Myopic and hyperopic laser in situ keratomileusis retreatments - Indications, techniques, limitations, and results

Purpose: To assess the efficacy of myopic and hyperopic laser in situ kerat omileusis (LASIK retreatment procedures, Setting: Mater Private Hospital, Dublin, Ireland. Methods: Retreatment was defined as either lifting the previously created f lap or when this was not possible, cutting a new flap. Fifty-six patients w ere retreated, 17 with hyperopia (Group 1) and 39 with myopia (Group 2). Th e mean preoperative spherical equivalent in Group 1 was +3.79 diopters (D) +/- 1.53 (SD) (range +1.75 to +812 D) and in Group 2, - 5.46 +/- 2.87 D (ra nge - 0.38 to - 15.25 D). Results: The indications for retreatment were undercorrection, decentration , epithelial ingrowth, and central island. Postoperatively, the mean spheri cal equivalents in Groups 1 and 2 were +1.11 +/- 2.02 D (range -1.75 to +5. 50 D) and -1.02 +/- 2.20 D (range +4.75 to -9.00 D), respectively. In Group 1, the uncorrected visual acuity (UCVA) was 6/12 or better in 5.8% preoper atively and in 35% postoperatively. In Group 2, the UCVA was 6/12 or better in 5.1% preoperatively and in 59.0% postoperatively, Although 29% of the h yperopic eyes and 8% of the myopic eyes lost 1 Snellen line of best correct ed visual acuity (BCVA), there was an improvement (of 1 or more lines) in B CVA in 12% and 49%, respectively. In cases that were decentered preoperativ ely, the postoperative optical zone ablation centration was better in 85.7% of Group 1 eyes and 61.5% of Group 2 eyes. Corneal complications following retreatment included peripheral scarring, epithelial ingrowth, Bowman's fo lds, and keratectasia. Conclusions: Both myopic and hyperopic retreatments resulted in a stable re fractive outcome. Myopic retreatments were superior to hyperopic retreatmen ts in both efficacy and safety, J Cataract Refract Surg 2001; 27.-1278-1287 0 (C) 2001 ASCRS and ESCRS.