Abstract
Abstract: :
Purpose: To evaluate visual outcomes following LASIK retreatments. Patients and Methods: This is a retrospective case series of 2264 consecutive eyes treated with LASIK surgery for myopia, hyperopia, or astigmatism using the LADARVision excimer laser (Alcon, Inc.). One and two year follow–up data were available for 1430 and 963 eyes respectively, allowing calculation of retreatment rates. Clinical outcomes at 3–months postoperatively including UCVA, BCVA and predictability (achieved minus attempted refractive correction) were evaluated in all eyes undergoing retreatment. Patient characteristics were evaluated for possible associations with retreatment outcome variables. Results:One hundred forty–four eyes (10.1%) underwent LASIK retreatment within 1 year following surgery. Two eyes that underwent LASIK retreatment received additional wavefront–guided enchancement for residual myopia. The two–year retreatment incidence was 11.0% (105 eyes). The average length of time between initial treatment and retreatment for eyes with 2–year follow–up was 6.7 months (SD 3.7 months), with 94% taking place within 1–year. Among the one–year group, myopic eyes requiring retreatment (130 eyes), mean spherical equivalent refraction (MRSE) before initial LASIK surgery was –5.98D (range –1.00 to –15.50D) and –0.74D (range +2.50 to –3.25D) before retreatment. In hyperopic eyes (12 eyes), MRSE before initial LASIK surgery was +2.78D (range +0.13 to +4.75D), and before retreatment, was +0.43D (range –1.75 to +2.63D). Mean pre–retreatment UCVA was 20/42 and postoperatively was 20/24. Postoperative UCVA was 20/20 or better in 71 of 133 eyes (53.4%) and or better 20/25 in 98 eyes (73.1%). Comparing pre– retreatment to postoperative BCVA, 5 of 102 (4.9%) of eyes gained ≥ 2 lines of vision and 5 eyes (4.9%) lost ≥ 2 lines of vision. Seventy–one eyes (71.0%) had a predictability of ± 0.50D. Mean predictability following retreatment was –0.23D (SD 0.48D). Patients less than age 40 undergoing retreatment were more likely to have better UCVA (68% 20/20 or better) following surgery compared to those older than 40 years (45% 20/20 or better, p=0.01). Worse visual outcomes of retreatment were not associated with initial or pre–retreatment MRSE. Conclusions: LASIK retreatments are effective for correcting residual refractive error after primary LASIK, yielding good visual outcomes. Older age was a risk factor for worse postoperative uncorrected vision
Keywords: refractive surgery: LASIK • clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: risk factor assessment