Effectiveness of laser-assisted subepithelial keratectomy to treat residual refractive errors after laser in situ keratomileusis

PURPOSE: To evaluate the effectiveness of laser-assisted subepithelial keratectomy (LASEK) to treat residual refractive errors after laser in situ keratomileusis (LASIK). SETTINGS: Isik Eye Clinic, Ankara, Turkey. METHODS: This retrospective study included 24 eyes of 15 patients who had retreatment by LASEK for residual refractive errors after myopic LASIK. All patients had examinations that included slitlamp biomicroscopy, subjective and cycloplegic refractions, uncorrected visual acuity (UCVA), best corrected visual acuity, corneal topography, and pachymetry preoperatively and postoperatively. Postoperative examinations were performed at 1 week and 1, 3, and 6 months. RESULTS: The patient cohort comprised 9 men and 6 women. The median spherical equivalent (SE) of attempted correction for retreatment with LASEK was -1.25 diopters (D). The median follow-up after LASEK was 11.5 months (range 6 to 16 months). At the end of the follow-up, the median SE of the refractive error was -0.38 D. The median UCVA increased from 20/45 before LASEK to 20/25 at the last follow-up visit, which was statistically significant (P<.001). After LASEK, significant postoperative haze developed in 5 eyes. In all 5 eyes, the estimated ablation depth was more than 40 mum and the SE of attempted correction was -2.00 D or greater. CONCLUSIONS: Laser-assisted subepithelial keratectomy retreatment in eyes with myopic regression after LASIK resulted in a significant improvement in UCVA that was comparable to the improvement after flap lifting. An SE of attempted correction greater than -2.00 D was associated with a significant rate of haze.