Refractive errors re-treatment after primary Lasik treatment
is known as Lasik enhancement, by exclusion of the causes of
residual errors after Lasik treatment of refractive errors, residual
errors may even be still a nightmare for not only the patient but
also the surgeon. The factors that can cause imperfect refractive
outcome after initial treatment by Lasik are variable and depend
on the surgeon skills, selection and preparation of the case, and
machine adjustment. The surgeon skills improvement is not within
the scope of this article as it needs special attention to many points
like training, corneal map reading and finally the decision of doing
or not. The case selection and preparation are not that far to the
previous point, but the tool is different as we need to analyze
the patient data on the base of age, occupation, and the number
of refractive errors. Meticulous refractive test and evaluation of
refractive status of the patient including manifest and cycloplegic
refraction tests, best corrected visual acuity recording including
pinhole test and recording the final visual outcome after treatment
by Lasik, all are important considerations. Machine adjustment,
calibration and regular maintenance are three important factors
controlling the dose of laser delivered to the tissue therefore they
control the outcome of the procedure.
