Flap lift and photorefractive keratectomy enhancements after primary laser in situ keratomileusis using a wavefront-guided ablation profile: Refractive and visual outcomes

PURPOSE: To analyze results of wavefront-guided laser vision correction retreatments performed either by lifting the original flap or by surface ablation over the flap. SETTING: Optical Express, Glasgow, United Kingdom. DESIGN: Retrospective case series. METHODS: This retrospective study included patients grouped according to whether they had flap lift enhancement or photorefractive keratectomy (PRK) performed over the LASIK flap. All retreatment procedures were performed with the Visx Star S4 IR excimer laser with wavefront-guided ablation profile derived from the iDesign aberrometer. Visual acuities, refractive outcomes, vector analysis of refractive cylinder and complications were analyzed in this study. The results of the last available clinical visit are presented. RESULTS: This retrospective study included 290 eyes of 202 patients divided into 2 groups: 119 eyes that had flap lift enhancement (Group A), and 171 eyes in which photorefractive keratectomy (PRK) was performed over the LASIK flap (Group B). The mean follow-up was 4.0 +/- 1.9 months in Group A and 4.2 +/- 1.6 in Group B. The mean postoperative manifest spherical equivalent was -0.01 +/- 0.35 D and +0.06 +/- 0.39 D in Groups A and B, respectively. The percentage of eyes with postenhancement UDVA 20/20 or better was 87.4% in Group A and 79.5 % in Group B (P =.09). In Group A, 22 eyes (18.5%) developed epithelial ingrowth, of which surgical intervention was required in 2 eyes (1.7%). Grade 1 or less haze was noted in 9 (5.3%) eyes in Group B, and resolved in all cases within the first 6 postoperative months. CONCLUSION: Both retreatment techniques were considered to be effective, predictable, and safe. (C) 2015 ASCRS and ESCRS