Myopic laser in situ keratomileusis retreatment: Incidence and associations

PURPOSE: To determine the factors associated with retreatment after laser in situ keratomileusis (LASIK) for myopic eyes in the modern LASIK era. SETTING: Care-Vision Laser Centers, Tel-Aviv, Israel. DESIGN: Retrospective cohort study. METHODS: All cases of myopic LASIK performed between January 2005 and December 2012 were analyzed according to whether they had retreatment refractive surgery. RESULT: The study evaluated 9177 right eyes in 9177 consecutive LASIK cases. The mean preoperative subjective spherical equivalent and astigmatism were -3.30 diopters (D) +/- 1.53 (SD) (range -0.50 to -12.00 D) and 0.69 +/- 0.94 D (range 0.00 to 6.00 D), respectively. Of the eyes, 165 (1.80%) had at least 1 retreatment. Over the course of the study, the 2-year retreatment rate decreased from 2.58% to 0.38% (P<.001). Multiple binary logistic regression analysis showed that older age (odds ratio [OR], 1.03; P = .007), higher astigmatism (OR, 1.23; P = .008), sphere (OR, 1.15; P = .026), and mean keratometric power (OR, 1.13; P = .036) significantly increased the odds for retreatment. A larger optical zone ablation (7.0 mm) significantly decreased the odds for retreatment (OR, 0.10; P = .022). Significant cutoffs associated with retreatments were age greater than 50 years, astigmatism more than 1.5 D, and sphere more than 2.0 D. CONCLUSIONS: Older age and higher preoperative astigmatism, sphere, and corneal steepness were associated with myopic LASIK retreatment. Larger optical ablation zones might decrease re treatment rates. (C) 2016 ASCRS and ESCRS