Purpose. Evaluation of the safety, efficacy, and predictability of wavefront guided excimer laser re-treatment of previous LASIK using the VISX WaveScan system and VISX STRAR S3 excimer laser system for patients where two or more lines of best corrected acuity had been lost due to the primary LASIK.

Methods. Treatment was performed in 7 eyes of 7 patients. Manifest refraction in bright light and mesopic conditions together with Pell-Robson contrast sensitivity assessment, 10% LogMAR acuity, Alcon EH 290 topograpghy and wavefront scanning was performed prior to surgery and at 1 week and 1, 3, 6 and 12 months after wavefront treatment. Data from the wavefront was used to create a custom lens through wich each patient acuity was assessed. Only if the wavefront correcting lens provided acuity as good as or better than manifest refraction did LASIK flap-lift excimer laser treatment take place.

Results. At 12 months, 5 of 7 eyes have reached this time point. Following secondary treatment, best spectacle corrected visual acuity improved by 2 or more lines in 4 cases, and 1 line in one case. No patient was worse after treatment.

Conclusions. Wavefront guide excimer laser re-treatment of ocular aberration using the VISK WaveScan wavefront scanner and the VISX STAR S3 excimer laser system with variable spot scanning produced clinically acceptable results