Factors Predicting the Need for Retreatment After Refractive Surgery

Tuesday, April 21, 2015: 1:31 PM
Room 1B (San Diego Convention Center)
Igor Kaiserman, MD MSC
Tzahi Sela
Gur Munzer
Shmuel Levartovsky, MD

To identify the potential risk factors that increase the likelihood of requiring retreatment following refractive surgery.

Setting: Care-Vision Laser Centers, Tel-Aviv, Israel. Design: Retrospective study.

Methods: Patients who underwent laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between January 2005 and December 2012. Patients were divided into two groups according to whether or not they underwent secondary refractive surgery (retreatment) during the study period.

41,504 eyes of 21,313 patients were included in the final analysis. Throughout the study period there was a significant reduction in the corrected annual retreatment rates from 8.12% for surgeries done in  2005 to 0.87% for surgery done in  2012 (Quadratic R2=0.95, P=0.01). The retreatment group had significantly older age, higher keratometric power, sphere, cylinder, and better BCVA. They were more likely to have preoperative hyperopia and were treated with PRK at a higher humidity levels and a lower temperature. Significant differences in retreatment rates were found between surgeons ranging from 0.48% to 3.14% (P<0.0001).

Several factors significantly predict the need for refractive retreatment iincluding preoperative age, astigmatism, hyperopia, operating room temperature and surgeon identity.