Recutting the cornea versus lifting the flap: comparison of two enhancement techniques following laser in situ keratomileusis.
OBJECTIVE
To evaluate enhancement techniques following laser in situ keratomileusis (LASIK).


METHODS
Recutting was performed on 263 eyes and the flap was lifted in 55 eyes that had LASIK for simple myopia or myopic astigmatism. The time interval between LASIK and retreatment was 340+/-46 days (range, 270 to 892 days) in the recutting group and 215+/-36 days (range, 53 to 617 days) in the flap lifting group. Mean spherical equivalent refraction, refractive cylinder, uncorrected and best spectacle-corrected visual acuity were examined prior to, and 1, 3, and 6 months after retreatment.


RESULTS
Seventeen eyes were lost to follow-up in the lifting group and 53 eyes in the recutting group. In the recutting group, mean spherical equivalent refraction improved from -1.48+/-1.25 D to -0.49+/-0.88 D at 6 months. In the flap lifting group, mean spherical equivalent refraction improved from -1.05+/-1.49 D to -0.45+/-0.39 D at 6 months. Refractive cylinder did not change significantly in either group (P = .2). There was a significant increase in uncorrected visual acuity (UCVA) of 6/6 in each group. In the recutting group, UCVA of 6/6 increased from 3.8% to 65.2% at 6 months, and in the lifting group from 3.6% to 71.1% at 6 months. In the recutting group, seven free flaps and three macerated flaps that required removal occurred. One eye in the recutting group and two in the lifting group developed significant epithelial ingrowth. No patient lost more than one line of best spectacle-corrected visual acuity (BSCVA).


CONCLUSIONS
Both procedures were safe, effective, and highly predictable for enhancements, but flap complications may be more likely with recutting.
Domniz
Y
Y
The Eye Institute, Chatswood, New South Wales, Australia.
Comaish
I F
IF
Lawless
M A
MA
Rogers
C M
CM
Sutton
G L
GL
D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D003315:Cornea / Q000601:surgery*; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D012029:Refraction, Ocular; D012086:Reoperation; D012449:Safety; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity