Hyperopic LASIK retreatments with the Technolas laser

PURPOSE: To evaluate the safety, efficacy, and predictability of hyperopic LASIK retreatments. METHODS: This retrospective, consecutive, non-comparative, observational study included 85 eyes that underwent hyperopic LASIK retreatment with 1-year follow-up. Complete ophthalmic examination included distance uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), cycloplegic refraction, and pachymetry. Patients were divided into two groups according to the preoperative spherical equivalent refraction: group 1, < or = +3.9 diopters (D) and group 2, > or = +4.0 D. RESULTS: The UCVA improved from 0.31 +/- 0.2 to 0.7 +/- 0.2 in group 1 and from 0.2 +/- 0.2 to 0.6 +/- 0.2 in group 2 following retreatment. Mean spherical equivalent refraction improved from +2.8 +/- 0.85 to +0.2 +/- 0.9 in group 1 and from +5.3 +/- 0.9 to +0.3 +/- 1.3 in group 2 after retreatment. In group 1, 32 (72.7%) of 44 eyes had BSCVA > or = 20/25, and in group 2, 24 (58.5%) of 41 eyes had BSCVA > or = 20/25. After primary hyperopic LASIK, 25 (56.8%) of 44 eyes in group 1 and 19 (46.3%) of 41 eyes in group 2 maintained BSCVA or gained > or = 1 lines postoperatively in contrast to 21 (47.7%) of 44 eyes in group 1 and 22 (53.9%) of 41 eyes in group 2 after retreatment. In group 1, 11 (25%) of 44 eyes lost > or = 2 lines of BSCVA after initial hyperopic LASIK compared to 14 (31.8%) of 44 eyes after retreatment. In group 2, 10 (24.4%) of 41 eyes lost > or = 2 lines of BSCVA after initial hyperopic LASIK compared to 12 (29.2%) of 41 eyes after retreatment. After hyperopic LASIK retreatment, 31 (70.5%) of 44 eyes in group 1 and 19 (46.4%) of 41 eyes in group 2 were within +/- 0.5 D of emmetropia. Safety was 0.9 in both groups and efficacy was 0.8 and 0.7 in groups 1 and 2, respectively. Complications included epithelial ingrowth of 1 to 3 mm (30%) and flap edge melting (2%). CONCLUSIONS: Hyperopic LASIK retreatment improved the refractive results of initial hyperopic LASIK surgery with 20% to 30% of eyes gaining > or = 1 lines of BSCVA. The loss of BSCVA was greater after primary hyperopic LASIK than after retreatment.