Re-treatment in LASIK: To Flap Lift or Perform Surface Ablation.

Chan, C; Lawless, M; Sutton, G; Hodge, C

Re-treatment in LASIK: To Flap Lift or Perform Surface Ablation.

Chan, C Lawless, M Sutton, G Hodge, C

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Publisher:: SLACK, Inc.
Publication Type:: Journal Article
Citation:: Journal of refractive surgery (Thorofare, N.J. : 1995), 2020, 36, (1), pp. 6-11
Issue Date:: 2020-01

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Field	Value	Language
dc.contributor.author	Chan, C
dc.contributor.author	Lawless, M
dc.contributor.author	Sutton, G
dc.contributor.author	Hodge, C https://orcid.org/0000-0002-0516-6486
dc.date.accessioned	2020-09-15T06:29:10Z
dc.date.available	2019-12-10
dc.date.available	2020-09-15T06:29:10Z
dc.date.issued	2020-01
dc.identifier.citation	Journal of refractive surgery (Thorofare, N.J. : 1995), 2020, 36, (1), pp. 6-11
dc.identifier.issn	1081-597X
dc.identifier.issn	1938-2391
dc.identifier.uri	http://hdl.handle.net/10453/142684
dc.description.abstract	PURPOSE:To review safety and efficacy outcomes following re-treatment for residual refractive errors in eyes with prior laser in situ keratomileusis (LASIK) and determine the most appropriate course of action for patients. METHODS:A review of all patients undergoing LASIK enhancement at a single refractive surgery center between 2012 and 2017 was undertaken. Refraction and biomicroscopy results before and after enhancement were collated and analyzed according to the method of enhancement (flap lift or surface ablation). RESULTS:A total of 108 eyes were included in the analysis; 58 eyes underwent flap lift and 50 underwent surface ablation retreatment with mean times to enhancement of 22.3 and 53.2 months, respectively. The mean spherical equivalent prior to enhancement was -0.43 ± 0.69 and -1.03 ± 1.01 diopters (D) for the flap lift and surface ablation groups, respectively. The absolute difference from intended refraction was statistically significant (lift 0.16 ± 0.24 versus surface ablation 0.31 ± 0.35 D; P = .01). The difference was more pronounced for eyes with prior hyperopia (P = .041). The incidence of haze following re-treatment was 3.4% in the flap lift group versus 10.0% in the surface ablation group, and 8.6% of the flap lift group had evidence of epithelial ingrowth, with 1 eye requiring washout. There was no correlation between time to enhancement, refraction, and incidence of complications following the enhancement procedure. CONCLUSIONS:There has been a trend toward treating residual LASIK refractive error through surface ablation. This review suggests that flap lift may result in a more accurate refractive outcome, albeit with an expected greater risk of epithelial ingrowth. [J Refract Surg. 2020;36(1):6-11.].
dc.format	Print
dc.language	eng
dc.publisher	SLACK, Inc.
dc.relation.ispartof	Journal of refractive surgery (Thorofare, N.J. : 1995)
dc.relation.isbasedon	10.3928/1081597x-20191211-02
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1113 Opthalmology and Optometry
dc.subject.classification	Ophthalmology & Optometry
dc.title	Re-treatment in LASIK: To Flap Lift or Perform Surface Ablation.
dc.type	Journal Article
utslib.citation.volume	36
utslib.location.activity	United States
utslib.for	1103 Clinical Sciences
utslib.for	1113 Opthalmology and Optometry
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Orthoptics
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-09-15T06:28:49Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	36
utslib.citation.issue	1

Abstract:

PURPOSE:To review safety and efficacy outcomes following re-treatment for residual refractive errors in eyes with prior laser in situ keratomileusis (LASIK) and determine the most appropriate course of action for patients. METHODS:A review of all patients undergoing LASIK enhancement at a single refractive surgery center between 2012 and 2017 was undertaken. Refraction and biomicroscopy results before and after enhancement were collated and analyzed according to the method of enhancement (flap lift or surface ablation). RESULTS:A total of 108 eyes were included in the analysis; 58 eyes underwent flap lift and 50 underwent surface ablation retreatment with mean times to enhancement of 22.3 and 53.2 months, respectively. The mean spherical equivalent prior to enhancement was -0.43 ± 0.69 and -1.03 ± 1.01 diopters (D) for the flap lift and surface ablation groups, respectively. The absolute difference from intended refraction was statistically significant (lift 0.16 ± 0.24 versus surface ablation 0.31 ± 0.35 D; P = .01). The difference was more pronounced for eyes with prior hyperopia (P = .041). The incidence of haze following re-treatment was 3.4% in the flap lift group versus 10.0% in the surface ablation group, and 8.6% of the flap lift group had evidence of epithelial ingrowth, with 1 eye requiring washout. There was no correlation between time to enhancement, refraction, and incidence of complications following the enhancement procedure. CONCLUSIONS:There has been a trend toward treating residual LASIK refractive error through surface ablation. This review suggests that flap lift may result in a more accurate refractive outcome, albeit with an expected greater risk of epithelial ingrowth. [J Refract Surg. 2020;36(1):6-11.].

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http://hdl.handle.net/10453/142684