Factors Predicting The Need For Retreatment After Laser Refractive Surgery In Patients With High Astigmatism: A Large Database Analysis

Published 2022 - 40th Congress of the ESCRS

Reference: PP06.09 | Type: ESCRS 2022 - Posters | DOI: 10.82333/gb1b-cw39

Authors: Michael Mimouni* ¹ , Igor Kaiserman ² , Ronen Spierer ² , Oriel Spierer ³ , Gilad Rabina ² , David Varssano ² , Nir Sorkin ⁴

¹Department of Ophthalmology,Rambam Health Care Campus,Haifa,Israel, ²Care Vision Laser Centers,Tel Aviv,Israel, ³Department of Ophthalmology,E. Wolfson Medical Center,Holon,Israel, ⁴Department of Ophthalmology,Tel Aviv Medical Center,Tel Aviv,Israel

Purpose

To identify the potential risk factors that increase the likelihood of requiring retreatment following refractive surgery in patients with high astigmatism (≥3D).

Setting

Care Vision Laser Center.

Methods

This retrospective study included patients who underwent laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between January 2005 and December 2019 at the Care-Vision Laser Centers, Tel-Aviv, Israel. Patients with high astigmatism (≥3D) were included and divided into two groups according to whether or not they underwent additional refractive surgery (retreatment) during the study period.

Results

Overall, 2,024 eyes (n=2,024) were included in this study. In total, 3.1% of the eyes (n=63) underwent retreatment. Throughout the study period, there was a significant reduction in the two-year annual retreatment rates with a decline from 7.0% for primary surgeries performed in 2005 to 0.0% for primary surgeries performed in 2017 (r=-0.65, p=0.015). The retreatment group had significantly older preoperative age. They were also more likely to be of male gender, have preoperative against-the-rule astigmatism and preoperative mixed astigmatism. Binary logistic regression analysis demonstrated that preoperative age, male gender, mixed astigmatism and earlier year of surgery were all associated with higher retreatment rates.

Conclusions

The following factors are associated with higher rates of retreatment in patients with high astigmatism: Older preoperative age, male gender and mixed astigmatism. These factors may be incorporated into nomograms in order to reduce future retreatment rates in this population.