J Ortega-Usobiaga1, F Llovet-Osuna2, T Katz3, M R Djodeyre4, V Druchkiv5, R Bilbao-Calabuig2, J Baviera6. 1. Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Bilbao, España. Electronic address: jortega@clinicabaviera.com. 2. Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Madrid, España. 3. Departamento de Catarata y Cirugía Refractiva, Care Vision, Hamburgo, Alemania; Departamento de Oftalmología, Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburgo, Alemania. 4. Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Zaragoza, España. 5. Departamento de Investigación y Desarrollo, Clínica Baviera, Valencia, España. 6. Departamento de Catarata y Cirugía Refractiva, Clínica Baviera, Valencia, España.
Abstract
PURPOSE: To assess visual outcomes of retreatment after laser in situ keratomileusis (LASIK) by lifting the flap or performing photorefractive keratectomy (PRK) on the flap, as well as to establish whether there was an increased risk of epithelial ingrowth (EIG) when LASIK and lifting of the flap are separated by a long time interval and to determine the incidence of corneal haze after PRK. METHODS: Retrospective study of 4077 patients (5468 eyes) who underwent LASIK and subsequent retreatment were reviewed in order to study their visual results and identify cases of EIG and corneal haze. RESULTS: Enhancements included 5196 eyes from 3876 patients that were retreated by lifting the flap, and 272 eyes from 201 patients that were retreated by PRK on the flap. No statistically significant differences were found between the retreatments in terms of predictability, efficacy, and safety. A total of 704 cases of EIG were found after lifting the flap, for which surgical cleansing was necessary in 70. Surgical cleansing decreased the efficacy index when compared with patients with EIG who did not need cleansing (P=.01). Differences in terms of safety and predictability were not statistically significant. The incidence of corneal haze after ablation of the surface of the previous flap was 14.34%, although none of these cases were clinically relevant. CONCLUSIONS: Visual outcomes were similar between patients who were retreated by lifting the flap and those who underwent PRK. The incidence of EIG when the flap was lifted was 13.55%. The incidence of EIG increases with the time elapsed between the primary procedure and retreatment.
PURPOSE: To assess visual outcomes of retreatment after laser in situ keratomileusis (LASIK) by lifting the flap or performing photorefractive keratectomy (PRK) on the flap, as well as to establish whether there was an increased risk of epithelial ingrowth (EIG) when LASIK and lifting of the flap are separated by a long time interval and to determine the incidence of corneal haze after PRK. METHODS: Retrospective study of 4077 patients (5468 eyes) who underwent LASIK and subsequent retreatment were reviewed in order to study their visual results and identify cases of EIG and corneal haze. RESULTS: Enhancements included 5196 eyes from 3876 patients that were retreated by lifting the flap, and 272 eyes from 201 patients that were retreated by PRK on the flap. No statistically significant differences were found between the retreatments in terms of predictability, efficacy, and safety. A total of 704 cases of EIG were found after lifting the flap, for which surgical cleansing was necessary in 70. Surgical cleansing decreased the efficacy index when compared with patients with EIG who did not need cleansing (P=.01). Differences in terms of safety and predictability were not statistically significant. The incidence of corneal haze after ablation of the surface of the previous flap was 14.34%, although none of these cases were clinically relevant. CONCLUSIONS: Visual outcomes were similar between patients who were retreated by lifting the flap and those who underwent PRK. The incidence of EIG when the flap was lifted was 13.55%. The incidence of EIG increases with the time elapsed between the primary procedure and retreatment.
Keywords:
Complicaciones de la PRK; Complicaciones del LASIK; Corneal epithelial ingrowth; Corneal haze; Crecimiento epitelial en la interfase; Haze corneal; LASIK; LASIK complications; Laser in situ keratomileusis; PRK; PRK complications; Photorefractive keratectomy; Queratectomía fotorrefractiva; Queratomileusis con láser in situ
Authors: Majid Moshirfar; Noor F Basharat; Nour Bundogji; Emilie L Ungricht; Ines M Darquea; Matthew E Conley; Yasmyne C Ronquillo; Phillip C Hoopes Journal: J Clin Med Date: 2022-08-18 Impact factor: 4.964