With such a thin untouched corneal thickness, I think the first step would be to determine how those numbers were derived. Estimating residual cornea by subtracting the intended flap thickness and the expected amount of laser ablation is notoriously inaccurate. Many doctors check the thickness of the corneal bed after flap creation and then subtract the expected amount of tissue removal. This is a much more accurate method, but can be affected by the variables of tissue ablation. Because your estimated residual corneal bed is so low, it would be very valuable to have a diagnostic test that can precisely determine the amount of untouched cornea you have available for enhancement surgery. The two devices that can accomplish this task are the Artimis and the Zeiss Visante Optical Coherence Tomography. These would have the ability to measure exactly the amount of tissue available and where it is located.
It may be that PRK on the Lasik flap would be a more appropriate alternative to Lasik enhancement surgery. The precise thickness of the flap is important, but the Artimis and Visante can evaluate this too.
Any study of Complex Wavefront Retreatment (CWR) is limited by the fact that every patient starts at a different and compromised vision ability. Since there is no common starting point, it is difficult to evaluate the end point. There are many case studies of individuals who have had CWR with great success, limited success, and a worsening of the visual symptoms. The vast majority have an improvement, but not all.
As a very general rule, CWR works best for people with elevated higher order aberration (HOA) spherical aberration, coma, and to a lesser extent secondary astigmatism.
There are so many variables that it will be very difficult for anyone here to advise you on what outcome you could reasonably expect, however there are CWR success stories.
Glenn Hagele
CRSQA
http://www.USAEyes.org
I am not a doctor.
