Safety and predictability of laser in situ keratomileusis enhancement by flap reelevation in high myopia.

Abstract

PURPOSE:

To evaluate the safety and predictability of laser in situ keratomileusis (LASIK) retreatment following primary procedures for high myopia and astigmatism.

SETTING:

Corneal Diseases and Excimer Laser Research Unit, Department of Ophthalmology, University of Dundee, Dundee, United Kingdom.

METHODS:

This prospective observational study of retreatment comprised a cohort of 109 eyes having primary LASIK for high myopia and astigmatism with a spherical equivalent (SE) of -9.70 diopters (D) +/- 4.06 (SD). Twenty-four eyes (22%) with an initial myopic SE of -9.83 +/- 3.50 D, a comparable subset of the entire group (P < .05), had retreatment for residual myopia (-3.02 +/- 2.17 D) to improve uncorrected visual acuity (UCVA) by reelevating the corneal flap and ablating the stromal bed.

RESULTS:

The mean follow-up after retreatment was 12.8 +/- 5.1 months (range 1.5 to 24 months; 19 eyes >/=6 months, 13 eyes > or = 12 months). The mean myopic SE was reduced to +0.53 +/- 0.62 D at 1 week, +0.05 +/- 0.50 D at 1 month, +0.30 +/- 0.50 D at 6 months, and +0.18 +/- 0.42 D at the latest follow-up, 12.8 months. At the latest review, 62% of eyes were within +/-0.50 D of emmetropia and 100% were within +/-1.00 D. The mean refraction did not alter statistically between 1 week and subsequent times. The mean UCVA improved from 6/30 prior to retreatment to 6/9 at the latest follow-up. Uncorrected visual acuity of 6/6 or better, 6/9 or better, and 6/12 or better was achieved by 33.0%, 75.0%, and 95.8% of eyes, respectively. No significant complications that led to a loss of best corrected visual acuity were encountered, although retreatment procedures were more uncomfortable than primary procedures and self-limiting; epithelial ingrowth that did not threaten vision was common, and 2 patients complained of nighttime visual symptoms.

CONCLUSIONS:

Retreatment of residual myopia by reelevating the flap was relatively safe and predictable, with a low risk of sight-threatening complications. However, longer term studies may be required to detect late complications.

• Authors: A Brahma, C N McGhee, J P Craig, A D Brown, K H Weed, J McGhee, R Brown
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 27 Issue 4 Pg. 593-603 (Apr 2001) ISSN: 0886-3350 [Print] United States
• PMID: 11311630 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Astigmatism (surgery)
• Cohort Studies
• Corneal Stroma (surgery)
• Female
• Humans
• Keratomileusis, Laser In Situ
• Male
• Middle Aged
• Myopia (surgery)
• Postoperative Complications
• Prospective Studies
• Refraction, Ocular
• Reoperation
• Safety
• Surgical Flaps
• Treatment Outcome
• Visual Acuity