Retreatment After Keratorefractive Lenticule Extraction: Risk Factors In Myopic And Myopic-Astigmatic Eyes
Published 2024 - 42nd Congress of the ESCRS
Reference: FP20.11 | Type: Free paper | DOI: 10.82333/6d9x-s563
Authors: Ziad Muqbel* 1 , Anika Förster 2 , Samer Alkarkoukly 3 , Samuel Arba-Mosquera 4 , H. Burkhard Dick 1 , Suphi Taneri 5
1Ruhr-University Bochum,Bochum,Germany, 2Center for Refractive Surgery,Muenster,Germany, 3Institute for Biomedical Informatics, University of Cologne,Medical Data Integration Center,Cologne,Germany, 4SCHWIND eye-tech solutions,Kleinostheim,Germany, 5Center for Refractive Surgery,Muenster,Germany;Ruhr-University Bochum,Bochum,Germany
Purpose
To identify potential risk factors that increase the likelihood of retreatment following Keratorefractive Lenticule Extraction (KLEx) for myopia and myopic astigmatism.
Setting
Eye Center at St. Francis Hospital, Münster, Germany
Methods
Retrospective study of patients with myopia and myopic astigmatism who underwent KLEx using the Visumax 500 (Carl Zeiss Meditec) laser between April 2015 and December 2020. Patients were divided into two groups: the control group and the retreatment group, if they had additional refractive surgery within 2 years of the primary treatment. The effect of different preoperative, intraoperative, and postoperative parameters on the retreatment rate was analyzed.
Results
Overall 1,822 eyes of 938 patients were analyzed. In total, 2.96 % of eyes (n = 54) underwent retreatment. The retreated patients were more likely to be female (highest odds-ratio) and have high myopia, high astigmatism, steep corneas, higher ocular residual astigmatism, residual myopic and/or astigmatic refractive error. In contrast, we found no significant correlation between retreatment rate and age, chord µ, type of astigmatism, nor corneal thickness. Most retreated patients opted for bilateral enhancements.
Conclusions
Factors associated with higher rates of retreatment after KLEx included female gender (which was unexpected and remains unexplained), manifest refractive high myopia (> -5 D), astigmatism (> 2 D), spherical equivalent (> 6 D), ocular residual astigmatism, steeper corneas, as well as postsurgical residual myopic and astigmatic refractive errors. This study may help to preoperatively detect patients at risk for retreatment, improve preoperative patient counselling, and optimize patient selection to reduce future retreatment rates.