Retreatment of residual refractive errors with flap lift laser in situ keratomileusis

PURPOSE. To investigate the outcomes of flap lift laser-assisted in situ keratomileusis (LASIK) for residual refractive errors. METHODS. In this prospective study, 60 eyes of 48 patients (mean age 36 years; age range 23-53 years) underwent flap lift retreatment surgery following initial LASIK for the correction of residual refractive errors. All treatments were wavefront guided using the VISX S4 Star excimer laser. The main outcome measures were predictability, safety, efficacy, and stability. RESULTS. Following retreatment, epithelial ingrowth occurred in 23.3% (n=14) of eyes, which required a flap lift and scrape procedure in 4 eyes and a second flap lift and scrape procedure in 2 eyes. De novo dry eye occurred in 8.3% (n=5) of eyes. At 6 months, the mean (+/- SD) post-retreatment Snellen decimal uncorrected visual acuity (UCVA), sphere, cylinder, spherical equivalent (SE), defocus equivalent (DE), and best corrected visual acuity (BCVA) was 1.03 +/- 0.23, 0.08 +/- 0.34 diopters (D) (range -0.75 to +1.25 D), -0.53 +/- 0.37 D (range 0 to -1.75 D), -0.04 +/- 0.34 D (range -1.11 to +1.04 D), 0.29 +/- 0.41 D (range 0 to 1.94 D), and 1.13 +/- 0.15 (range 0.5 to 1.5), respectively. Seventy-three percent (n=44) of eyes had an UCVA equal to or greater than 1 (6/6), 88.3% (n=53) and 98.3% (n=59) of eyes were within +/- 0.50 D and +/- 1.00 D of SE, respectively, and 3.3% (n=2) of eyes lost 1 line of BCVA. CONCLUSIONS. A high incidence (23.3%, n=14) of epithelial ingrowth occurred following retreatment surgery and de novo dry eye occurred in 8.3% (n=5) of eyes. Despite this, reasonable visual and refractive outcomes were achieved at 6 months post-retreatment.