LASIK Enhancement: Clinical and Surgical Management

PURPOSE: To review refractive regression and current therapeutic options for patients who have residual refractive error after LASIK. METHODS: An extensive literature search using PubMed was performed for terms such as "LASIK," "PRK," "enhancement," "overcorrection," "undercorrection," "relift," "mini-flap," and related terms. RESULTS: The presence of residual refractive error following LASIK is a challenging situation. After excluding anatomical causes (eg, ocular surface disease, cataract, and macular pathology) and intraoperative flap complications, evaluation of the residual stromal bed must be performed. Depending on the length of time since primary LASIK, procedures such as flap re-lift, flap re-cut, and surface ablation may be performed. CONCLUSIONS: Residual refractive errors can be seen after LASIK surgery and may benefit from an enhancement procedure. Different options are available for enhancement, each requiring proper evaluation and an analytical approach to make the procedure safe and effective.