Retreatment after initial laser in situ keratomileusis.
OBJECTIVE
To report the results of laser in situ keratomileusis (LASIK) retreatment in patients with primary undercorrection and with postoperative regression and to assess the efficacy and safety of LASIK retreatment.


METHODS
The Eye Institute of Utah, Salt Lake City, Utah, USA.


METHODS
The prospective study included 157 eyes of 108 patients. Using the VISX Star laser, retreatments were performed for undercorrection in 43 eyes (27%) and for regression in 114 eyes (73%). The mean follow-up was 15 months (range 6 to 28 months) after the initial surgery and 10 months (range 3 to 25 months) after the repeat LASIK procedure.


RESULTS
Overall, the mean spherical equivalent (SE) was -6.11 +/- 2.35 diopters (D) (range -1.87 to -15.00 D) before LASIK and -1.28 +/- 0.57 D (range -0.50 to -3.25 D) prior to retreatment. At the last visit, it was -0.23 +/- 0.41 D (range -2.55 to 1.13 D). One hundred fifty-three eyes (97.5%) were within +/-1.00 D of emmetropia and 128 (81.5%), within +/-0.50 D. The uncorrected visual acuity was 20/20 or better in 68.8% of eyes and 20/40 or better in 98.1%. In all eyes, the best corrected visual acuity (BCVA) improved or remained within 1 line of the pre-revision level. However, 2 eyes (1.3%) lost 2 or more lines of pre-initial LASIK BCVA. Both eyes had a preoperative SE greater than -8.00 D; corneal irregularity was the cause of the decrease in vision.


CONCLUSIONS
Several conclusions can be drawn from this study. First, LASIK retreatment is effective and safe for correcting undercorrection and regression after initial LASIK, and a good visual outcome is expected. Second, in most eyes, regression occurs within 6 months after the initial LASIK. However, regression can develop up to 2 years after LASIK. Third, multiple retreatments will be required in some patients. The outcome in these cases is promising.
Lyle
W A
WA
Eye Institute of Utah, Salt Lake City 84107, USA.
Jin
G J
GJ
D000328:Adult; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D012029:Refraction, Ocular; D012086:Reoperation; D012307:Risk Factors; D014792:Visual Acuity