Recutting, flap lifting both effective in LASIK enhancements

CHATSWOOD, Australia — Both recutting and relifting the flap are safe, effective and highly predictable methods for LASIK enhancement, according to a retrospective study conducted at The Eye Institute here. Flap complications may be more likely with recutting, the study found.

Of 318 eyes that had enhancement of LASIK surgery between 1996 and 1999 at The Eye Institute, 82.7% underwent enhancement with recutting of the cornea, and 17.3% with lifting of the flap. Surgeons performed recutting when the flap edge could not be easily identified. Postop exams were conducted at 1 week, 1 month, 3 months, and 6 months.

In the recutting group, mean refraction improved from -1.48 ±1.25 D before retreatment to -0.49 ±0.88 D at 6 months postop. The flap lifting group showed similar results, with mean refraction improving from -1.05 ±1.49 D before retreatment to -0.45 ±0.39 D at 6 months postop.

Yuval Domniz, MD, and colleagues noted that during the retreatments early in the study period, recutting the flap was more common. With this technique there was less chance of inducing epithelial ingrowth than with lifting the flap. In the study, 3 eyes (0.9%) had significant epithelial ingrowth: two in the flap-lifting group and one in the recutting group.

The study authors recommended excluding patients with corneal ectasia using serial corneal topography and pachymetry.

The full results of the study appear in the Sept./Oct. issue of the Journal of Refractive Surgery.