LASIK Enhancement: Lifting Versus Recutting

Laser in situ keratomileusis (LASIK) enhancement surgery can be performed safely and effectively by either lifting or recutting a flap, but lifting the flap may show better long-term stability of refractive error and uncorrected acuity, according to Minnesota Eye Consultants of Minneapolis, Minn.

In a retrospective case-control study, investigators compared visual outcomes and incidence of complications of lifting versus recutting the lamellar flap in LASIK enhancement surgery. Investigators included 212 consecutive eyes undergoing LASIK enhancement procedures at a single surgery location during a 5-year period. In all cases they evaluated uncorrected visual acuity, best-corrected visual acuity, refractive error, and complications. Relifting of flaps was performed in 164 of 212 eyes (77.4 percent); recutting of flaps was performed in 48 of 212 eyes (22.6 percent).

Investigators observed no significant differences in early visual outcomes between the two groups. At 1 year, patients had significantly better uncorrected vision if the flap was lifted rather than recut (20/24.7 vs. 20/31.3). In addition, the flap lift group had a significantly more stable refraction at 1 year than did the recut group (change in spherical equivalent: +0.05 diopters (D) vs. -0.57 D). The incidence of complications did not differ significantly between the two groups.

SOURCE: Davis EA, Hardten DR, Lindstrom M, et al. LASIK enhancements: A comparison of lifting to recutting the flap. Ophthalmol 2002;109(12):2308-13.