Strategies for the management and prevention of complications in refractive laser surgery
Strategieën voor behandeling en het voorkomen van complicaties van refractiechirurgie met de laser
Objective. Reoperations after refractive surgery have increased in frequency during the past 10 years. The spectrum of the indications for repeat LASIK may have changed. Methods. All cases of reoperations after refractive surgery performed between May 1, 2004 and April 30, 2005 at the Institute of Refractive and Ophthalmic Surgery (IROC) were retrospectively investigated regarding indication for repeat surgery and visual and refractive results. The 1-month results were used to estimate the refractive and visual success rate. Results. Of the 76 reoperations, 69 were performed as re-lifts, 3 eyes had new lamellae cut, and 3 cases needed keratoplasty. The reoperations took place 7.5±13 months after the primary operation (range 0.5 to 60 months). The most frequent indication was residual astigmatism of 0.5 D and more. Visual loss of more than 1 decimal line did not occur and unaided visual acuity increased from 0.64 to 1.05. No complications were reported, however, 3 eyes needed additional enhancement. Conclusions. Reoperations after LASIK performed as re-lifts appear to be effective and reasonably safe when using the technique described and respecting a residual stromal thickness of 280 microns.
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