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LASEK corrects residual myopia after primary LASEK, study finds

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Laser epithelial keratomileusis enhancement appears to be effective for the correction of residual myopia after initial LASEK, a small study has found.

Bernhard Gabler, MD, and colleagues at the University of Regensburg (Germany) eye clinic performed enhancement with LASEK on 10 eyes that had been treated for myopia initially with LASEK. The initial preop mean spherical equivalent was –6.2 D, and residual spherical equivalent after primary LASEK was –1.6 D.

The criteria for retreatment included a spherical equivalent of –0.5 D or worse, uncorrected visual acuity of 20/30 or worse and patient dissatisfaction with visual outcome after primary LASEK. Two eyes were retreated for residual myopia and eight for regression. The mean time between primary and secondary LASEK surgeries was 7 months.

All eyes experienced an increased adherence of the epithelium in the central cornea, the study authors said.

“With careful preparation, an intact epithelial flap could be created in all 10 eyes. In four eyes, alcohol was reapplied for an additional 10 to 15 seconds because of strong central epithelial adherence,” the authors reported in the July issue of Journal of Cataract & Refractive Surgery.

After the enhancement surgery, all eyes had 20/25 or better visual acuity. Visual acuity was 20/20 in no eyes before the enhancement and in eight eyes after enhancement.

According to the authors, the retreatment procedure was identical to the primary LASEK procedure, with the exception of a longer alcohol exposure time in the repeat surgery.

“Repeated LASEK seems to be a valuable technique for the correction of residual myopia after primary LASEK,” the authors reported. They acknowledged that longer follow-up and larger series are necessary for definitive assessment.