PURPOSE To review safety and efficacy outcomes following re-treatment for residual refractive errors in eyes with prior laser in situ keratomileusis (LASIK) and determine the most appropriate course of action for patients. METHODS A review of all patients undergoing LASIK enhancement at a single refractive surgery center between 2012 and 2017 was undertaken. Refraction and biomicroscopy results before and after enhancement were collated and analyzed according to the method of enhancement (flap lift or surface ablation). RESULTS A total of 108 eyes were included in the analysis; 58 eyes underwent flap lift and 50 underwent surface ablation retreatment with mean times to enhancement of 22.3 and 53.2 months, respectively. The mean spherical equivalent prior to enhancement was -0.43 ± 0.69 and -1.03 ± 1.01 diopters (D) for the flap lift and surface ablation groups, respectively. The absolute difference from intended refraction was statistically significant (lift 0.16 ± 0.24 versus surface ablation 0.31 ± 0.35 D; P = .01). The difference was more pronounced for eyes with prior hyperopia (P = .041). The incidence of haze following re-treatment was 3.4% in the flap lift group versus 10.0% in the surface ablation group, and 8.6% of the flap lift group had evidence of epithelial ingrowth, with 1 eye requiring washout. There was no correlation between time to enhancement, refraction, and incidence of complications following the enhancement procedure. CONCLUSIONS There has been a trend toward treating residual LASIK refractive error through surface ablation. This review suggests that flap lift may result in a more accurate refractive outcome, albeit with an expected greater risk of epithelial ingrowth. [J Refract Surg. 2020;36(1):6-11.].

中文翻译：

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在LASIK中重新治疗：皮瓣提升或进行表面消融。

目的回顾现有激光原位角膜磨镶术（LASIK）对残留屈光不正进行再治疗后的安全性和疗效，并确定最适合患者的治疗方案。方法回顾性分析2012年至2017年间在单个屈光手术中心接受LASIK增强术的所有患者。根据增强方法（皮瓣剥离或表面消融）对增强前后的折射和生物显微镜检查结果进行整理和分析。结果分析共纳入108只眼。58眼进行了皮瓣抬起，50眼进行了表面消融再治疗，平均改善时间分别为22.3和53.2个月。增强前的平均球当量为-0.43±0.69和-1.03±1。襟翼提升和表面消融组分别为01屈光度（D）。与预期屈光度的绝对差在统计学上是显着的（升力0.16±0.24与表面消融0.31±0.35 D； P = 0.01）。有先天性远视的眼睛之间的差异更为明显（P = .041）。皮瓣抬起组再治疗后混浊的发生率为3.4％，而表面消融组为10.0％，皮瓣抬起组的8.6％有上皮向内生长的迹象，其中一只眼睛需要冲洗。强化手术后的强化，屈光时间和并发症发生率之间没有相关性。结论有一种通过表面消融治疗残余LASIK屈光不正的趋势。这项审查表明，皮瓣抬高可能导致更准确的屈光结果，尽管上皮向内生长的风险更大。[J Refract Surg。2020; 36（1）：6-11。]。