Retreatment using LASIK, PRK, or ICL for myopic regression after corneal laser refractive surgery

To describe the outcomes of retreatment for myopic regression following primary LASIK or PRK, and to explore factors associated with pre-retreatment refractive error.

Retrospective cross-sectional study of eyes undergoing retreatment with LASIK, PRK, or ICL implantation after prior LASIK/PRK. Outcomes included UDVA, CDVA, MRSE, and safety and efficacy indices through 6-12 months. Associations between baseline factors and pre-retreatment MRSE were assessed.

158 eyes were included (136 LASIK, 12 PRK, 10 ICL). Early postoperative outcomes improved significantly for LASIK (UDVA 0.37 to 0.04 logMAR; MRSE - 1.28 D to - 0.12 D) and ICL (UDVA 0.68 to 0.03 logMAR; MRSE - 2.72 D to 0.03 D). PRK also produced significant UDVA gains (0.63 to 0.06 logMAR). Efficacy and safety indices were near or above 1.0 across groups. A longer interval since primary surgery was significantly linked to more negative MRSE, consistent with greater regression. Mild correlation between pre-retreatment MRSE and age, initial MRSE, and tissue ablation were observed. Complications were low (7.9%).

Retreatment for myopic regression with LASIK, PRK, or ICL was safe and effective, with stable outcomes through 6-12 months. Regression was multifactorial and not predicted by baseline characteristics, though longer intervals between surgeries were significantly associated with greater myopic regression.