PURPOSE To evaluate the outcomes of transepithelial, topography-guided, epithelial mapping-assisted ablation in the treatment of regression after myopic refractive surgery. METHODS A retrospective consecutive case series of 70 eyes of 52 patients with regression after previous corneal refractive surgery for treatment of myopic and compound myopic astigmatism underwent re-treatment using transepithelial topography-guided and epithelial mapping-assisted custom ablation with a wide and smooth transition zone design. The ablation profile was based on data from corneal topography, whereas the epithelial ablation depth was decided by corneal epithelial mapping obtained by optical coherence tomography. RESULTS The mean follow-up time after re-treatment was 13.6 ± 9.4 months (range: 6 to 51 months). At the patients' last follow-up visit, 98.5% and 76.5% had uncorrected distance visual acuity of 20/40 and 20/20 or better. Safety and efficacy indexes were 1.05 and 0.92, respectively. The mean spherical equivalent was reduced from -1.10 ± 0.65 to -0.16 ± 0.34 diopters. Both total root mean square, odd-order, and even-order higher order aberrations improved significantly (P = .021, .040, and .030, respectively), whereas corneal asphericity remained unchanged (P = .662). Epithelial thickness profile showed significant smoothing between the central 2-mm and 2- to 5-mm paracentral areas. CONCLUSIONS Transepithelial topography-guided and epithelial mapping-assisted custom re-treatment with a wide and smooth transition zone design is safe and effective for addressing myopic regression in patients who have previously undergone myopic refractive surgery. [J Refract Surg. 2019;35(8):525-533.].

中文翻译：

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经上皮地形图引导的消融辅助上皮厚度图治疗近视屈光手术后的回归。

目的评估近视屈光手术后经上皮，地形学指导，上皮标测辅助消融治疗预后的结果。方法回顾性分析52例70眼患者的回顾性连续病例，该病例在过去角膜屈光手术后，用于治疗近视和复合性近视散光，并采用经上皮地形图引导和上皮标测辅助的习惯性消融，并在宽而平滑的过渡区进行再次治疗设计。消融轮廓基于角膜地形图的数据，而上皮消融深度由光学相干断层扫描获得的角膜上皮标测确定。结果复治后的平均随访时间为13.6±9.4个月（范围：6至51个月）。在患者的最后一次随访中，为98。5％和76.5％的未矫正远视力为20/40和20/20或更高。安全性和有效性指数分别为1.05和0.92。平均球当量从-1.10±0.65降低到-0.16±0.34屈光度。总均方根，奇数阶和偶数阶高阶像差均显着改善（分别为P = .021，.040和.030），而角膜非球面度保持不变（P = .662）。上皮厚度分布显示在中心2 mm和2至5 mm中心旁区域之间明显平滑。结论经上皮地形引导和上皮标测辅助的定制再治疗具有宽广且平滑的过渡区设计，对于解决以前接受过近视屈光手术的患者的近视消退是安全有效的。[J Refract Surg。2019; 35（8）：525-533。]。5％的未矫正远视力为20/40和20/20或更高。安全性和有效性指数分别为1.05和0.92。平均球当量从-1.10±0.65降低到-0.16±0.34屈光度。总均方根，奇数阶和偶数阶高阶像差均显着改善（分别为P = .021，.040和.030），而角膜非球面度保持不变（P = .662）。上皮厚度分布显示在中心2 mm和2至5 mm中心旁区域之间明显平滑。结论经上皮地形引导和上皮标测辅助的定制再治疗具有宽广且平滑的过渡区设计，对于解决以前接受过近视屈光手术的患者的近视消退是安全有效的。[J Refract Surg。2019; 35（8）：525-533。]。5％的未矫正远视力为20/40和20/20或更高。安全性和有效性指数分别为1.05和0.92。平均球当量从-1.10±0.65降低到-0.16±0.34屈光度。总均方根，奇数阶和偶数阶高阶像差均显着改善（分别为P = .021，.040和.030），而角膜非球面度保持不变（P = .662）。上皮厚度分布显示在中心2 mm和2至5 mm中心旁区域之间明显平滑。结论经上皮地形引导和上皮标测辅助的定制再治疗具有宽广且平滑的过渡区设计，对于解决以前接受过近视屈光手术的患者的近视消退是安全有效的。[J Refract Surg。2019; 35（8）：525-533。]。