To lift or recut: changing trends in LASIK enhancement.

PURPOSE To report serious complications caused by recutting laser in situ keratomileusis (LASIK) flaps for enhancement and reconsider the current preferred method of LASIK enhancement. SETTING Multiple surgeon practices. METHODS This retrospective noncomparative nonconsecutive case series comprised LASIK patients in the private practices of 9 experienced refractive surgeons and those reported in a survey of refractive surgeons. Case histories, refractions, corneal topographies, slitlamp photographs, and measurements of uncorrected and best corrected (BCVA) visual acuity after recutting LASIK flaps were collected. Surveys of refractive surgeons and an analysis of changing practice trends among the authors and these surgeons were assessed. RESULTS In 12 cases, significant loss of BCVA and subjective visual difficulties resulted from recutting LASIK flaps. Most surveyed surgeons had changed their practice from recutting to lifting flaps even 9 to 10 years postoperatively with good results. CONCLUSION Recutting flaps for enhancement should be avoided unless other alternatives are unavailable.