PURPOSE To identify the potential risk factors that increase the likelihood of requiring re-treatment following refractive surgery in patients with high astigmatism (3.00 diopters or greater). METHODS This retrospective study included patients who underwent laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between January 2005 and December 2019 at the Care-Vision Laser Centers, Tel-Aviv, Israel. Patients with high astigmatism (3.00 diopters or greater) were included and divided into two groups according to whether or not they underwent additional refractive surgery (re-treatment) during the study period. RESULTS Overall, 2,024 eyes (2,024 patients) were included in the final analysis of this study. In total, 3.1% of the eyes (n = 63) underwent re-treatment. Throughout the study period, there was a significant reduction in the 2-year annual re-treatment rates, with a decline from 7.0% for primary surgeries performed in 2005 to 0.0% for primary surgeries performed in 2017 (r =-0.65, P = .015). The re-treatment group had significantly older preoperative age. They were also more likely to be male and have preoperative against-the-rule astigmatism and preoperative mixed astigmatism. Binary logistic regression analysis demonstrated that preoperative age, male gender, mixed astigmatism, and earlier year of surgery were all associated with higher re-treatment rates. CONCLUSIONS The following factors are associated with higher rates of re-treatment in patients with high astigmatism: older preoperative age, male gender, and mixed astigmatism. These factors may be incorporated into nomograms to reduce future re-treatment rates in this population. [J Refract Surg. 2021;37(6):366-371.].

中文翻译：

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预测高度散光患者激光屈光手术后需要再治疗的因素：大型数据库分析。

目的 确定增加高度散光（3.00 屈光度或更大）患者屈光手术后需要再次治疗的可能性的潜在风险因素。方法 这项回顾性研究纳入了 2005 年 1 月至 2019 年 12 月在以色列特拉维夫 Care-Vision 激光中心接受激光原位角膜磨镶术 (LASIK) 或屈光性角膜切削术 (PRK) 的患者。包括高散光（3.00 屈光度或更大）的患者，并根据他们在研究期间是否接受额外的屈光手术（再治疗）分为两组。结果 总的来说，本研究的最终分析包括 2,024 只眼（2,024 名患者）。总共有 3.1% 的眼睛（n = 63）接受了再治疗。在整个学习期间，2 年年度再治疗率显着降低，从 2005 年进行的初次手术的 7.0% 下降到 2017 年进行的初次手术的 0.0%（r =-0.65，P = .015）。再治疗组术前年龄明显偏大。他们也更可能是男性，并且有术前违规散光和术前混合散光。二元逻辑回归分析表明，术前年龄、男性、混合散光和手术时间较早均与较高的再治疗率相关。结论 下列因素与高度散光患者较高的再治疗率相关：术前年龄较大、男性和混合散光。这些因素可能会被纳入列线图中，以降低该人群未来的再治疗率。[J 屈光手术。2021;37(6):366-371.]。