J Korean Ophthalmol Soc.  2015 Feb;56(2):180-189. 10.3341/jkos.2015.56.2.180.

Clinical Outcome of Retreatment after Refractive Surgery

• Lee EJ
• Lim DH
• You JY
• Chung TY
• Chung ES

• KMID: 2216000
• DOI: http://doi.org/10.3341/jkos.2015.56.2.180

Abstract

PURPOSE
To evaluate the clinical outcome of retreatment after refractive surgery.
METHODS
Retrospective analysis of 38 eyes of 24 patients who received retreatment surgery after refractive surgery from August 2008 to May 2013 was performed. Pre-initial surgery characteristics and the reason for retreatment were investigated, and preand post-retreatment uncorrected visual acuity, best corrected visual acuity, safety index, efficacy index, predictability, and postoperative complication were also investigated.
RESULTS
Age at initial refractive surgery and retreatment were 28.50 +/- 7.29 years (17-49 years) and 31.21 +/- 6.49 years (21-49 years). Reasons for retreatment were myopic regression in 36 eyes (94.7%) and overcorrection in two eyes (5.3%). Methods of retreatment were laser subepithelial keratomileusis (LASEK) in 31 eyes (81.6%) and laser-assisted in situ keratomileusis (LASIK) in seven eyes (18.4%). Safety index values for all were above 1.0 and efficacy index values were 0.92, 0.93, and 0.95 in postoperative examination at 1 month, 3 months, and 6 months, respectively. No eye showed a decrease in best corrected visual acuity. One eye had transient hyperopia after retreatment, and two eyes had postoperative corneal opacity, but no eye experienced significant alteration in visual prognosis.
CONCLUSIONS
Retreatment after refractive surgery was an efficient and safe clinical course in our clinic. No long-term complications were observed, and uncorrected visual acuity and refractive errors significantly improved after retreatment. In particular, LASEK can be considered as a safe and efficient retreatment modality without risk of keratectasia.

Keyword

LASEK; LASIK; Myopic regression; Refractive surgery; Retreatment

MeSH Terms

Corneal Opacity
Humans
Hyperopia
Keratectomy, Subepithelial, Laser-Assisted
Keratomileusis, Laser In Situ
Postoperative Complications
Prognosis
Refractive Errors
Refractive Surgical Procedures*
Retreatment*
Retrospective Studies
Visual Acuity

Figure

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  Figure 1. Change in BCVA from preinitial surgery and the last visit. BCVA = best-corrected visual acuity.

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  Figure 2. Safety index and efficacy index at post-retreatment 1 month, 3 months, and at last visit (values are based on 33, 23, and 34 eyes, respectively). SI = safety index, defined as post-retreatment best-corrected visual acuity/pre-retreatment best-corrected visual acuity; EI = efficacy index, defined as post-retreatment uncorrected visual acuity/best-corrected visual acuity.

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  Figure 3. Predictability of post-retreatment spherical equivalent (values are based on 36, 38, 33, 23, and 13 eyes, re-spectively). D = diopter.

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  Figure 4. Predictability of post-retreatment spherical equivalent over time (at post-retreatment 1 month, 3 months, and 6 months). SE = spherical equivalent; D = diopter.

Reference

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