Secondary ametropia retreatment with flap lifting performed long after LASIK surgery: a clinical case

Purpose : to present a clinical case of secondary ametropia retreatment with flap lifting, which was performed long after a LASIK surgery. Material and methods . A female patient who experienced a regression of the refraction effect after a LASIK surgery, received a flap lifting with keratoablation 18 years after the primary LASIK surgery. 8 days following this procedure, the patient developed a complication, namely an epithelial ingrowth. Another flap lifting procedure was performed and the epithelial ingrowth was removed. Results . The expected refractive effect was achieved with binocular hypocorrection as planned. Conclusion . A repeated flap lifting undertaken 3 years or more after the first LASIK or FemtoLASIK surgery increases the risk of a complication — an epithelial ingrowth into the space under the flap. To avoid the complication in such cases, the retreatment by PRK is preferable. Scarification and elimination of the in-grown epithelial should be performed early after the surgery.