الفهرس 
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Abstract
Summary
Hyperopia is also known as “farsightedness” or “hypermetropia”. It is an ocular condition in which the refracting power of the eye causes light rays entering the eye to have a focal point that is posterior to the retina while accommodation is maintained in a state of relaxation. Visual acuity is better at far (e.g. 6 meters) distances than at near (e.g. 0.33 meters) distances.
LASIK (laser-assisted in situ keratomileusis), commonly referred to as laser eye surgery or laser vision correction, is a type of refractive surgery for the correction of myopia, hyperopia, and astigmatism. The LASIK surgery is performed by an ophthalmologist who uses a laser or microkeratome to reshape the eye’s cornea in order to improve visual acuity.
Angle kappa is defined as the angle between the visual axis (line connecting the fixation point with the fovea) and the pupillary axis (line that perpendicularly passes through the entrance pupil and the center of curvature of the cornea).
Eyeglasses or contact lenses are the most common methods of correcting hyperopia symptoms. They work by refocusing light rays on the retina, compensating for the shape of your eye. They can also help protect your eyes from harmful ultraviolet (UV) light rays. A special lens coating that screens out UV light is available.
In other cases, people may choose to correct hyperopia with LASIK or another similar form of refractive surgery. These surgical procedures are used to correct or improve your vision by reshaping the cornea, or front surface of your eye, effectively adjusting your eye’s focusing ability.
There are several complications of lasik as dryness, halos, Diffuse lamellar keratitis, flap complication …… etc.
Between flap complication there are ablation of back of the flap.
Our aim of work were Comparison between standard and customized up decentration of the flap during lasik in hyperopic patients in protection of the flap from laser ablation.
This study was designed to be a randomized assessing 100 eyes with hyperopia.
One hundred eyes with hyperopia were included in this study. The eyes were divided into two groups. In group A (50 eyes); the flap was intentionally shifted up during flap creation. In group B (50 eyes) was done without flap decentration.
In our study there was a statistical significant difference between both groups regarding the post operative complications as the ablation of back of flap was higher in non decentration group (14.3%) than the decentration group 0(0%) and patient satisfaction as all patients of decentration group were satisfied 28 (100%) on contrary to the decentration group only 24 (85.7%) were satisfied (P-value<0.05).
In hyperopic lasik we should consider pupil offset. We should centralized the flap with corneal reflex not with the center of the pupil.
Conclusions
The results of this study confirm that flap decentration during hyperopic LASIK correction has a better results with higher safety and efficacy in flap protection from ablation with good results in refraction and BCVA post lasik surgery.