Abstract

Purpose To evaluate the outcome of the reversal of myopia correction in patients intolerant to LASIK. Methods This study is a retrospective and case series of patients who decided to reverse their previous myopic LASIK correction between July 2012 and July 2020. It was conducted at a private refractive surgery centre, Ismailia, Egypt. The patients were followed up after reversal treatment for one year. Primary LASIK and reversal treatment were performed by a 500 kHz Amaris excimer laser platform. The main outcomes included refractive predictability, stability, efficacy, and safety and any reported complications. Results This study included 48 eyes of 24 patients (6 male and 18 female patients). The average duration between the primary LASIK surgery and reversal treatment was 3.20 ± 0.30 months (range 3 to 4 months). Reversal treatment was bilateral in all patients. The mean age of the patients was 38 ± 1.9 years (range 37 to 45 yrs). After reversal, the mean postreversal cycloplegic refraction spherical equivalent was −1.82 ± 0.34 D (range −1.50 to −3.00 D). The mean ablation depth was 34.10 ± 7.36 μm (range 20 to 46 μm), and the mean of the central corneal thickness 12 months after reversal treatment was 510.2 ± 14.4 μm (range 515 to 487 μm). The mean keratometric reading was 42.6 ± 1.6 (range 42.5 to 44.8). The mean of CDVA was 0.2 ± 0.03 log MAR (range −0.10 to 0.4 log MAR). The mean optical zone of reversal treatment was 6.1 ± 0.3 mm (range 5.9 to 6.2 mm). UDVA was 0.4 log MAR in 87.5% of the patients, 0.5 log MAR in 8.3% of the patients, and 0.6 log MAR in 4.2% of the patients. CDVA remained unchanged in 83.3% of patients; 2.1% of the patients gained one line of CDVA (Snellen); 8.3% of the patients lost one line of CDVA; 6.3% of the patients lost two lines of CDVA. No cases of corneal ectasia were recorded. The only postoperative complications were flap microfolds in 3 eyes (6.25%). Conclusion In conclusion, this study demonstrates that reversal of myopic LASIK treatment is a safe, stable, and effective option for intolerant patients.

Highlights

  • Laser-assisted in situ keratomileusis (LASIK) is the most common refractive procedure to correct different refractive errors, including hyperopia, myopia, and astigmatism [1]

  • Reversal treatment was bilateral in all patients. e mean age of the patients was 38 ± 1.9 years

  • The demand for myopia refractive surgery has risen significantly. is is due to objective performance in terms of better-unaided vision and reduced refractive error, but it depends on patient satisfaction after surgery [16]

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Summary

Introduction

Laser-assisted in situ keratomileusis (LASIK) is the most common refractive procedure to correct different refractive errors, including hyperopia, myopia, and astigmatism [1]. E result is the patient’s freedom from contact lenses and glasses [2] It has been shown in several studies to enhance visual function and patient quality of life (QOL) [3,4,5,6]. Unless the patient’s expectations of the procedure were unreasonable, patient satisfaction should be high after an uneventful refractive surgery with a good objective result. Failure to conduct a thorough subjective evaluation can prevent the visualization of particular dissatisfaction areas [8,9,10]. In their analysis, Kahle and coauthors [8] discovered that 84% of patients were pleased with their myopic correction after surgery, whereas 16% were indifferent or dissatisfied. El-Maghraby et al [9] found that 90.5% were pleased, and 9.5% were unhappy overall. ere have been reports of at least temporary losses of low-contrast visual acuity and contrast sensitivity [11,12,13,14]

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