Retreatment after LASIK: Method and Results

¹Frisch L. H. J., ²Pfaff S., ¹Breil P., ¹Dick H. B., ¹Pfeiffer N.,
¹Johannes-Gutenberg-Universität Mainz, Universitäts-Augenklinik (Mainz)
²Fachhochschule Aalen (Aalen)

In residual refractive errors after laser in situ keratomileusis (LASIK) retreatment may be necessary in the state of refractive stability. The corneal flap is lifted and laser ablation is performed. Cutting of an additional flap is regarded as obsolete.
Patients and method: In an interval of two years 19 retreatments in 19 eyes of 16 patients were performed. Refraction before LASIK was hypermetropic in 4 eyes and myopic in 15 eyes (7 of which ≥-8.0 dpt). Three eyes had astigmatism of more than 2.0 diopters. Retreatment was performed in median 119 days after LASIK. The reason for retreatment was undercorrection in 10 cases, overcorrection in 7 cases and eccentric ablation in two eyes. The point tip of a forceps yaw was used to enter the epithelium. The epithelium was incised and the flap lifted with a retreatmnet spatula. The following laser ablation was performed using the ESIRIS excimer laser (Schwind, Germany) with a larger optical zone than in the original LASIK treatment.
Results: 17 of the 19 treated eyes were within a range of ±1.0 dpt of spherical equivalent, the two cases of eccentric ablation required a second retreatment. Postoperative follow-up after three months showed stable refractive conditions. Flap complications such as striae or epithelial ingrowth were not seen.
Conclusions: Retreatment after LASIK is a safe and stable method. Nevertheless, the necessity of continuous and consequent development of a nomogram is of highest importance in order to avoid retreatments.

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