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PK Chiang, PS Hersh; Outcomes of Laser in situ Keratomileusis Retreatment for Residual Myopia and Astigmatism . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4145.
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Purpose: To assess the visual and refractive outcomes of laser in situ keratomileusis (LASIK) retreatment on eyes with residual myopia with or without astigmatism Methods: LASIK retreatments were performed on 91 eyes of 80 patients for the correction of residual myopia, with or without astigmatism. Mean manifest spherical equivalent refraction was -1.30 diopters (D) ±0.66 (SD) and mean refractive astigmatism was -0.77 ±0.51 D. Before retreatment, 42 (46%) patients showed an uncorrected visual acuity (UCVA) of 20/40 or better while 3 (3%) patients were 20/20 or better. Retreatment was performed an average of 209 ±161 days after primary LASIK. All retreatments were performed by lifting the original flap of the previous LASIK. Laser ablation was then performed using the Summit Apex Plus excimer laser in 26 eyes and the Autonomous LADARVision excimer laser in 65 eyes. Results: At three months or later follow-up, manifest spherical equivalent refraction was reduced to a mean of -0.53 ±0.54 D, and refractive astigmatism was reduced to a mean of -0.40 ±0.50 D. Fifty-seven percent of eyes were within 0.50 D of emmetropia compared to 3% of eyes before retreatment. Ninety-eight percent of eyes improved to an UCVA of 20/40 or better, while 74% of eyes achieved an UCVA of 20/25 or better. Fifty-one percent of patients had an UCVA of 20/20 or better. Complications included flap striae, and sublamellar epithelium and debris in four eyes. Of these, one eye lost more than one line of best-corrected visual acuity. This eye improved to a best-corrected visual acuity of 20/20 after phototherapeutic keratectomy (PTK). One eye required a second LASIK retreatment for residual myopia. Conclusion: LASIK retreatment of eyes with residual myopia with or without astigmatism after primary LASIK resulted in improved visual and refractive outcomes. There was a low incidence of complications, and none were vision threatening.
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