I had RK in 1984 and like many others have been hyperopic since day one. I was able to accommodate for about two years, then was put into RGP's and until last month wore RGP's reverse curve lens. I decided to look into further corrective surgery and have a consultation this week with a top surgeon in Southern California. I have worn soft lenses and glasses for the past month in an effort to find my end point. It astonished me to find that my glass prescription has gone from R +4.25 X -0.75 X 84, L + 5.50 X -2.25 X 65 to R +6.50 X-1.50 X 92, L +7.75 X -4.00 X 75, add +1.75. Since I was initially before RK surgery -3.25 X -1.00 both eyes I am amazed at the overcorrection and hyperopic shift over the years.

My conventional wisdom and research indicates that I am probably out of range of Lasik with a corneal thickness of 495 and K readings of 38. I will get more current readings this week. Obviously, topographies and other tests are necessary for final conclusions.

Any comments from surgeons who have performed post RK corrections on hyperopes?

Your conventional wisdom and reasearch are correct. You are out of the range for LASIK particularly in the left eye due to the amount of astigmatism you have. You could consider clear lens extraction with placement of a toric lens implant (lens implant for astigmatism). However, the predictability of knowing which power implant to use after RK surgery is a bit tricky and sometimes unpredicatable. However, you have a good chance of substantially reducing your farsightedness with this procedure. An ophthalmologist experienced in clear lens extraction could help you explore your options. Best of luck.
Steven Ofner, M.D.
Eugene, Oregon
http://www.eugeneeyecare.com