Flap-Lift LASIK 10 or More Years After Primary LASIK.

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.].