Outcomes After Laser In Situ Keratomileusis (Lasik) Requiring Surgical Intervention

Abstract

Abstract: : Purpose: To report the visual outcomes after complications of laser in situ keratomileusis (LASIK) that required surgical intervention. Methods: A retrospective consecutive review was performed on 4,051 eyes of 1726 patients who underwent LASIK from January 1998 to August 2001 at an Institutional practice in a tertiary care eye center with a freestanding refractive surgical center. After primary LASIK and routine enhancement 31 eyes of 30 patients required 43 surgical procedures. Primary outcome measures were uncorrected and best-corrected visual acuity. Results: The mean age (± SEM) of the 30 patients who required surgical intervention for complications after LASIK was 46.3 ± 2.1 years. Eight eyes had had routine enhancement. Among 31 eyes that had surgical intervention for complications after primary LASIK and/or routine LASIK enhancement, corneal flap elevation and irrigation were required in 11 eyes for corneal striae, 7 eyes for diffuse lamellar keratitis, 18 eyes for debridement of epithelial ingrowth, and 5 for flap positioning and/or striae. There was no significant difference between mean preoperative and postoperative BCVA for all patients or any subgroup, and mean postoperative UCVA was 1 line worse (20/25) than mean preoperative BCVA (20/20) (p=0.01). Conclusions: Following primary LASIK and routine LASIK enhancement procedures, complications requiring surgical intervention are uncommon. When such complications occur, proper surgical management generally provides a favorable prognosis with preservation of the preoperative level of BCVA as well as preservation of generally satisfactory UCVA.

Keywords: refractive surgery: complications • refractive surgery: LASIK • cornea: clinical science