title: To lift or recut: changing trends in LASIK enhancement.
abstract: OBJECTIVE
  To report serious complications caused by recutting laser in situ keratomileusis (LASIK) flaps for enhancement and reconsider the current preferred method of LASIK enhancement.
  
  
  METHODS
  Multiple surgeon practices.
  
  
  METHODS
  This retrospective noncomparative nonconsecutive case series comprised LASIK patients in the private practices of 9 experienced refractive surgeons and those reported in a survey of refractive surgeons. Case histories, refractions, corneal topographies, slitlamp photographs, and measurements of uncorrected and best corrected (BCVA) visual acuity after recutting LASIK flaps were collected. Surveys of refractive surgeons and an analysis of changing practice trends among the authors and these surgeons were assessed.
  
  
  RESULTS
  In 12 cases, significant loss of BCVA and subjective visual difficulties resulted from recutting LASIK flaps. Most surveyed surgeons had changed their practice from recutting to lifting flaps even 9 to 10 years postoperatively with good results.
  
  
  CONCLUSIONS
  Recutting flaps for enhancement should be avoided unless other alternatives are unavailable.
authors.affiliation: Washington Eye Physicians and Surgeons, Chevy Chase, MD 20815, USA.
authors.forename: Roy S
authors.initials: RS
authors.lastname: Rubinfeld
authors.forename: David R
authors.initials: DR
authors.lastname: Hardten
authors.forename: Eric D
authors.initials: ED
authors.lastname: Donnenfeld
authors.forename: Raymond M
authors.initials: RM
authors.lastname: Stein
authors.forename: Douglas D
authors.initials: DD
authors.lastname: Koch
authors.forename: Mark G
authors.initials: MG
authors.lastname: Speaker
authors.forename: Joseph
authors.initials: J
authors.lastname: Frucht-Pery
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Kameen
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Negvesky
mesh_terms: D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects* / Q000639:trends*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D014786:Vision Disorders / Q000209:etiology / Q000601:surgery; D014792:Visual Acuity