Predictors For Re-Treatment Following Lasik For High Myopia
Published 2025 - 43rd Congress of the ESCRS
Reference: PP15.15 | Type: Free paper | DOI: 10.82333/j94b-0g79
Authors: Ana Margarida Ferreira* 1 , Pedro Marques-Couto 1 , Ana Cunha 2 , Pedro Neves-Cardoso 2 , João Pinheiro-Costa 3 , Luís Torrão 2 , Rodrigo Vilares Morgado 2
1Ophthalmology,ULS São João,Porto,Portugal, 2Ophthalmology,ULS São João,Porto,Portugal;Surgery and Physiology,Faculty of Medicine of University of Porto,Porto,Portugal, 3Faculty of Medicine of University of Porto,Porto,Portugal
Purpose
This study aims to identify risk factors for re-treatment following laser-assisted in situ keratomileusis (LASIK) in eyes with high myopia.
Setting
Care Vision Laser Center, Tel Aviv, Israel.
Methods
This retrospective analysis included 2100 eyes that underwent initial LASIK between January 2000 and June 2022 at the Care Vision Laser Centers in Israel. Eyes were divided into two groups based on whether they required additional refractive surgery (2020 controls, 80 re-treatments). Preoperative parameters, including demographics and refractive measurements, were analyzed using independent t-tests and Chi-square tests. Intraoperative parameters were compared using independent t-tests, Mann-Whitney U tests, and Chi-square tests where appropriate. A logistic regression model incorporating variables that reached a significance level of less than 0.1 in univariate analysis was used to identify predictors of re-treatment.
Results
Preoperatively, re-treatment eyes had steeper minimum axis (p=0.011), shorter contact lens-free intervals (p=0.029), and a higher rate of baseline cylinder < –1.0 D (32.5% vs. 21.9%, p=0.025). Uncorrected and best-corrected visual acuity also slightly differed (P<0.05). Intraoperatively, re-treatment eyes had higher treated cylinder (p=0.043), greater ablation depth (p=0.004), and differences in optic zone selection (more 6.0 mm, p<0.001). Re-treatments were more common in earlier surgery dates and with EX200 laser use (p<0.05). Logistic regression adjusting for near-significant factors identified two independent predictors: higher baseline cylinder (< –1.0 D; OR 1.819, p=0.030) and EX200 laser use (OR 3.180, p<0.001).
Conclusions
Re-treatment following LASIK in eyes with high myopia is independently associated with a higher baseline refractive cylinder (< -1.0 D) and the use of older laser technology (EX200). These findings underscore the impact of both patient-specific refractive characteristics and advancements in surgical technology on long-term refractive outcomes. Enhancing patient selection criteria and adopting modern laser platforms may reduce the risk of additional refractive procedures in high myopia LASIK candidates. Future research should focus on refining these predictors to further optimize surgical protocols and improve overall outcomes.