Laser-assisted subepithelial keratectomy retreatment after laser in situ keratomileusis

Abstract

Purpose: To evaluate the efficacy and safety of laser-assisted subepithelial keratectomy (LASEK) retreatment after laser in situ keratomileusis (LASIK).

Setting: Mater Private Hospital, Dublin, Ireland.

Methods: In this retrospective study, 22 eyes of 20 patients had LASEK retreatment for residual refractive errors after LASIK. All patients who had the procedure between January 2004 and May 2007 were included in the study. The main outcome measures at the final follow-up visit were efficacy, predictability, safety, and stability.

Results: The mean spherical equivalent (SE) was -4.50 diopters (D)+/-2.88 (SD) (range -10.00 to +3.87 D) before LASIK and -1.23+/-0.95 D (range -2.50 to +2.00 D) after LASIK. The mean time between the initial LASIK procedure and LASEK enhancement was 56.2+/-24.3 months (range 6 to 84 months). The mean follow-up after retreatment was 6.68+/-6.47 months (range 3 to 24 months). At the final follow-up visit, 19 eyes (86.4%) had an uncorrected visual acuity of 20/30 or better and 17 eyes (77.3%) were within +/-1.00 D of the target refraction. No patient lost more than 1 line of best corrected visual acuity or developed corneal haze greater than grade 1.

Conclusion: Results indicate that LASEK retreatment after LASIK is a safe and effective alternative when LASIK retreatment is deemed unsafe because there is not sufficient residual corneal stromal bed or when retreatment is required many years after LASIK and relifting the original flap is expected to be problematic.