LASIK Enhancement Surgery: When a Touch-Up Makes Sense

Why vision might need a touch-up

LASIK reshapes the cornea to a target, and the cornea then heals. In most eyes the healed result matches the target closely. In some, the tissue responds a little more or less than predicted and a small prescription remains; this is called under- or over-correction and is judged at about three months. Separately, some eyes change over the years, particularly nearsighted eyes that were still drifting slowly and eyes moving through the lens changes of the mid forties. Neither means the LASIK failed; it means the eye has moved on.

Who is eligible

An enhancement is offered when:

• The residual prescription is large enough to affect your vision in a way that matters to you
• The prescription has been stable for several months
• Corneal tomography shows a regular, healthy cornea with no sign of ectasia
• Enough corneal thickness remains for a further treatment with a safe margin left over
• Dry eye and the ocular surface are well controlled

If the remaining tissue is not sufficient, the safer answers are glasses for specific tasks, a contact lens, or, for older patients, a lens based procedure that leaves the cornea alone.

How an enhancement is performed

Within roughly the first few years after LASIK the original flap can usually be lifted at its edge rather than re-cut, and the excimer treatment is applied beneath it exactly as it was the first time. The procedure is shorter than the original because the flap already exists. Later on, or when the flap is not suitable for lifting, a surface treatment (PRK) over the flap is often preferred, with the slower surface healing that PRK involves.

Cost

For LASIK performed at our practice, your original written quote explains exactly what is included, including how a future enhancement would be handled, subject to the eligibility criteria above. Enhancements after LASIK performed elsewhere are quoted in writing after the evaluation.