Regression

Moderate regression may occur after excimer laser assisted conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, and Epi-Lasik. This occurs mostly in myopic patients who have more than 6.0 diopters of refractive error and virtually all hyperopic patients.

After excimer laser assisted refractive surgery the cornea tends to regress back toward the original refractive error. The epithelium and the deeper stroma can reshape and reform at different rates and can cause regression.

Most Lasik and All-Laser Lasik patients experience regression within the first few weeks after surgery, while the surface ablation techniques of PRK, LASEK, and Epi-Lasik may require additional time until regression has settled down. For myopic patients, regression usually occurs within the first one to three months after surgery. Hyperopic patients may experience regression for a longer period of time. In all cases, it is reasonable to expect regression stop within the normal six month healing period.

Regression that is severe or continues to progress may be a sign of ectasia.

NearVision CK is considered a temporary procedure because the effects regress at a rate of about 0.33 diopter per year until all effects have dissipated.

Regression is a natural component of the healing process and is considered in the planned correction. A patient may be deliberately overcorrect to accommodate expected levels of regression. See Lasik Overcorrection Information

Regression occurs more commonly with smaller ablation diameters and with abrupt transition zones at the edge of the treatment areas. Steroid medications can be used to regulate and control regression. Although regression seems to be more prevalent the higher the refractive error, regression can occur in anyone.

If you are ready to choose a doctor to be evaluated for conventional or custom wavefrontt Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

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Current Regression Medical Journal News...

Pachymetric ratio no-history method for intraocular lens power adjustment after excimer laser refractive surgery.

Related Articles

Pachymetric ratio no-history method for intraocular lens power adjustment after excimer laser refractive surgery.

Ophthalmology. 2009 Jun;116(6):1057-66

Authors: Geggel HS

OBJECTIVE: To evaluate a new pachymetric method not requiring pre-refractive surgical data for adjusting the intraocular lens (IOL) power in eyes undergoing cataract surgery after excimer laser refractive surgery and comparing final refractive results with previously published formulas or methods. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Thirty-six eyes from 23 patients who had uneventful phacoemulsification cataract surgery after previous myopic (35) or mixed astigmatism (1) excimer laser photoablation. METHODS: A new corneal ratio (Geggel ratio) method was developed to estimate the diopters (D) of previous excimer treatment or change in spherical equivalent (SE) at the corneal plane. A regression formula, 0.40 (|DeltaSE|-1), predicted the correction factor to be added to the SRK/T (Sanders, Retzlaff, Kraff) formula. The IOL results from the Geggel and Geggel-real (modified for mild myopia) method were compared with the Masket, Koch double K table, Ladas, Walter, modified Maloney, clinical history, Feiz standardized and nomogram, Latkany average and flat, Ferrara, Rosa, Savini, Jin, Shammas no-history and regression formula, Seitz, and Awwad methods. The SRK/T, Hoffer, and Holladay formulas were tested in appropriate formulas. All IOL powers were converted to refractive results using IOL(exact) equations. MAIN OUTCOME MEASURES: Mean +/- standard deviation (SD), range, absolute mean +/- SD, and percent within +/-0.5 D, +/-1.0 D, and -1.0/+0.5 D. RESULTS: The pachymetric technique minimizes hyperopic surprises with 92% of eyes within -1.0/+0.5 D and no overcorrections >0.5 D with the Geggel-real modification. Final refractive results with the Geggel, Geggel-real, Masket, Koch double K tables, Latkany average and flat, Savini, Shammas no-history, Seitz Holladay, Seitz Hoffer, and Awwad Hoffer all had >55% SE +/-0.5 D and >85% SE +/-1.0 D of the surgical goal. The best results with fewer hyperopic overcorrections were found in 5 methods that comprise a new consensus group: Geggel-real, Shammas no-history, Savini, Latkany flat, and Seitz Hoffer. The consensus group had 96% of eyes within -1.0/+0.5 D of the surgical goal. CONCLUSIONS: The Geggel-real method is a new approach requiring no historical data to determine IOL power in this ever-enlarging and challenging group of former refractive surgery patients undergoing routine cataract surgery. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

PMID: 19371955 [PubMed - indexed for MEDLINE]