Contact pneumotonometry measures the IOP reliably after laser in situ keratomileusis for myopia, whereas Goldmann applanation tonometry underestimates the intraocular pressure. This may be important in the treatment of any future glaucoma.

<p>ABSTRACT</p><p>PURPOSE: To evaluate the efficacy of wavefrontguided ablation for treatment of residual refractive error and higher order aberrations after laser in situ keratomileusis (LASIK) for myopia.</p><p>METHODS: Twenty-one eyes of 13 patients with residual refractive error after myopic LASIK were treated with a wavefront-guided ablation with the Zyoptix technique. In 13 eyes of 8 patients (Group A) we lifted the flap with an epitheliorhexis technique; in 8 eyes of 5 patients (Group B) we cut a new flap with a Hansatome microkeratome.</p><p>RESULTS: Preoperative root mean square (RMS) values were 1.370 for second order aberrations, 0.382 for total higher order aberrations, 0.273 for third order, 0.243 for fourth order, and 0.052 for fifth order aberrations. Three months postoperatively, RMS values decreased significantly to 0.278 (second order), 0.189 (total higher order), 0.138 (third order), 0.107 (fourth order), and 0.038 (fifth order). Ablation depth was two times greater than needed with a standard Planoscan treatment. Patients in the microkeratome re?ut group showed a trend toward overcorrection, and residual astigmatism was higher (-0.75 ? 0.58 D) than in the flap lift group (-0.25 ? 0.29 D).</p><p>CONCLUSIONS: Wavefront-guided ablation was an effective method to correct residual refractive error and higher order aberrations after myopic LASIK. Functional and refractive outcomes were better when we lifted the flap than when we re?ut the flap. [J Refract Surg 2004;20:439-443]</p>

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