Flap-Lift LASIK 10 or More Years After Primary LASIK

Caster, Andrew I. MD, FACS

From Caster Eye Center Medical Group, Beverly Hills, California.

The author has no financial or proprietary interest in the materials presented herein.

Correspondence: Andrew I. Caster, MD, FACS, Caster Eye Center Medical Group, 9100 Wilshire Blvd., Suite 265 E, Beverly Hills, CA 90212. E-mail: [email protected]

Received November 22, 2017

Accepted June 20, 2018

Journal of Refractive Surgery 34(9):p 604-609, September 01, 2018. | DOI: 10.3928/1081597X-20180703-02

PURPOSE:

To evaluate the safety and efficacy of flap-lift LASIK performed 10 or more years after the original LASIK procedure.

METHODS:

All patients who were treated with flap-lift LASIK 10 or more years after primary LASIK for whom records of the primary treatment could be obtained and at least 45-day follow-up refractions after re-treatment were available were included in this study. A total of 23 eyes of 20 patients were identified. The median time between primary LASIK and flap-lift LASIK was 13.9 years (range: 10 to 18.7 years).

RESULTS:

A total of 22 of 23 eyes (96%) retained the same corrected distance visual acuity (CDVA) postoperatively that was present preoperatively. One of 23 eyes (4%) experienced a loss of CDVA from 20/20 to 20/25 as the result of clinically significant epithelial ingrowth requiring multiple treatments followed by photorefractive keratectomy (PRK) treatment. One additional eye experienced clinically significant epithelial ingrowth that required a single surgical treatment. Fourteen of 20 eyes with a goal of plano achieved uncorrected distance visual acuity (UDVA) of 20/20 or better and 6 eyes achieved UDVA of 20/25 (2 of these eyes had preoperative CDVA of 20/25). For the eyes with a goal of plano, 16 of 20 eyes (80%) achieved UDVA equal to the preoperative CDVA.

CONCLUSIONS:

Flap-lift LASIK is an effective treatment for refractive error when performed between 10 and 18.7 years after the initial flap was created. Epithelial ingrowth is the major complication, occurring to a clinically significant degree in 9% of the eyes.

[J Refract Surg. 2018;34(9):604–609.]