Management of Residual Refractive Errors After LASIK

Abstract

This essay discussed several options with the patient and differentiated between those that would mainly be advantageous to addressing the refractive error (i.e., lower-order aberration) and those that would mainly address the halos and glare (i.e., higher-order aberrations). The surgical options included: (1) PRK, (2) topography-driven laser treatment, (3) Intacs ring segments (Addition Technology, Inc., Des Plaines, Illinois), Photorefractive keratectomy: PRK would effectively reduce the refractive error; however, it would also come with the risk of further corneal surgery, resulting in additional decrease of the optical zone. This would likely aggravate the patient’s night glare symptoms. Topography-driven treatment: Although the goal of this treatment is enlargement of the optical zone to decrease the halo and glare phenomena, it is currently unavailable in some countries. Intrastromal ring segments: INTACS also offers the option of providing a larger optical zone. The largest drawback is its refractive predictability, which is uncertain given the history of bilateral high myopic LASIK and enhancements.