This page is for patients with long-sightedness (hyperopia) who are researching laser eye surgery and want to understand why Blue Fin Vision® has chosen not to perform hyperopic LASIK or PRK.
The Clinical Position
Blue Fin Vision® does not perform hyperopic laser surgery. This is a deliberate clinical position informed by long-term regression data in hyperopic LASIK and PRK series. Published five-to-ten-year follow-up studies demonstrate regression of 30–50% of the initial correction in many hyperopic cases.¹ ² The mechanism is the steeper central cornea created by hyperopic ablation, which tends to revert toward its original shape over time. A hyperopic laser patient may be 20/20 at six months and +1.5D or +2.0D at five years. That long-term instability is inconsistent with the premium pathway Blue Fin Vision® offers.
Correcting a prescription today at the cost of a reliable result in five years is not in the patient’s interest. Not performing a procedure that cannot deliver stable long-term outcomes is a clinical decision, not a commercial limitation.
Why Myopic Laser Is Different
Myopic LASIK flattens the central cornea. That flattening is stable, published ten-year data shows greater than 95% stability for moderate myopia.³ The mechanism that drives hyperopic regression, the steepened cornea reverting toward its pre-operative shape, does not apply to myopic ablation because the biomechanical pressure works in the opposite direction. Myopic LASIK and hyperopic LASIK are different procedures with different long-term outcome profiles, even though they use the same laser.
The Alternatives for Hyperopic Patients
Toric ICL for hyperopia plus astigmatism; spherical ICL for pure hyperopia without astigmatism (EVO Visian ICL, +0.5D to +5.5D range); refractive lens exchange (RLE) for patients over 45 or with early lens changes; and spectacles or contact lenses for patients who do not wish to proceed with intraocular surgery.⁴ Each option is discussed at consultation with the specific clinical rationale for that patient’s age, anatomy, and prescription.
Who This Is Not For
This page is not a criticism of providers who continue to offer hyperopic laser surgery. The decision on whether to perform it is a clinical judgement each practice makes for itself. Blue Fin Vision®’s position reflects experience with long-term outcomes and a preference for procedures that deliver stable results at five and ten years.
Clinical Perspective
At Blue Fin Vision®, Mr Mfazo Hove advises every hyperopic patient at consultation of the regression data and the rationale for recommending ICL or RLE over hyperopic laser. Patients who arrive expecting to be offered hyperopic LASIK sometimes leave with a different understanding of what the long-term data shows, and a recommendation grounded in five-to-ten-year outcomes rather than six-month refraction. The procedure that looks attractive at six months but drifts by year five is not the procedure Blue Fin Vision® offers.
Clinical Takeaway
Blue Fin Vision® does not perform hyperopic laser surgery because published long-term data shows regression of 30–50% of the initial correction at five to ten years in many hyperopic cases. The mechanism, a steepened cornea reverting toward its pre-operative shape, is specific to hyperopic ablation and does not affect myopic LASIK. Hyperopic patients at Blue Fin Vision® are directed toward ICL or refractive lens exchange, procedures without the regression mechanism.
References
- Jaycock PD, O’Brart DPS, Rosen ES, Marshall J. Five-year follow-up of LASIK for hyperopia. Ophthalmology. 2005;112(2):191–199.
- Salz JJ, Stevens CA; LASIK World Literature Review Quality of Life Subcommittee. LASIK correction of spherical hyperopia, hyperopic astigmatism, and mixed astigmatism with the LADARVision excimer laser system. Ophthalmology. 2002;109(8):1647–1656.
- Pesando PM, Ghiringhello MP, Di Meglio G, Fanton G. Posterior chamber phakic intraocular lens (ICL) for hyperopia: ten-year follow-up. J Cataract Refract Surg. 2007;33(9):1579–1584.
- Alio JL, Grzybowski A, El Aswad A, Romaniuk D. Refractive lens exchange. Surv Ophthalmol. 2014;59(6):579–598.
