title: Laser-assisted subepithelial keratectomy enhancement of residual myopia after primary myopic LASEK: six-month results in 10 eyes.
abstract: OBJECTIVE
  To determine whether residual myopia after primary laser-assisted subepithelial keratectomy (LASEK) can be corrected by repeated LASEK and whether this procedure is safe and effective.
  
  
  METHODS
  University Eye Clinic, University of Regensburg, Regensburg, Germany.
  
  
  METHODS
  Laser-assisted subepithelial keratectomy was performed in 10 eyes that had had primary LASEK for myopia. The initial mean spherical equivalent (SE) was -6.2 diopters (D) (range -2.5 to -8.0 D), and the residual mean SE was -1.6 D (range -1.0 to -3.0 D). The retreatment ratio was 7.6%. The exposure time of the corneal epithelium to alcohol (20% ethanol) was 30 seconds plus an additional 10 to 15 seconds in cases of strong epithelial adherence. Laser ablation was performed with a Keracor 117 excimer laser (Chiron Technolas). The follow-up after the second LASEK treatment was 6 months.
  
  
  RESULTS
  The epithelial flap for repeated LASEK was successfully created in all 10 eyes. The postoperative course in the eyes was uneventful. Six months after LASEK enhancement, the SE refraction was within +/-0.5 D in all eyes. No eye lost more than 1 line of best corrected visual acuity, and the uncorrected visual acuity was 20/20 or better in 8 eyes. Significant haze was not observed after repeated LASEK (mean 0.35 before and 6 months after LASEK enhancement).
  
  
  CONCLUSIONS
  Laser-assisted subepithelial keratectomy enhancement appears to be safe and effective for the correction of residual myopia after primary LASEK. Repeated epithelial flap preparation is possible without technical modifications.
authors.affiliation: University Eye Clinic, University of Regensburg, Regensburg, Germany. gabler@eye-regensburg.de
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gabler
authors.forename: Christoph
authors.initials: C
authors.lastname: Winkler von Mohrenfels
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herrmann
authors.forename: Felix
authors.initials: F
authors.lastname: Gora
authors.forename: Chris P
authors.initials: CP
authors.lastname: Lohmann
mesh_terms: D000328:Adult; D003316:Corneal Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000009:adverse effects; D012029:Refraction, Ocular; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity