Enhancement Procedures for Lasik Eye Surgery

LASIK, short for laser in-situ keratomileusis, is the most widely used type of laser eye surgery to correct the vision impairments of nearsightedness, farsightedness and astigmatism. In all of these cases, the patient has an abnormal cornea (the clear front window of the eye, responsible for proper focus) that causes light to not focus properly on the retina, which, in turn, causes vision impairment. LASIK is an extremely fast and safe procedure, with minimal side effects and recovery time. Sometimes, however, a follow-up enhancement procedure is needed in case of undercorrection, overcorrection or complication.

Satisfaction Variables

• A number of factors affect a LASIK surgery patient's overall satisfaction following the initial procedure. The health and state of the cornea (the clear front window of the eye that affects how light reaches the retina) is a major factor, since the corneal tissue is the focus of surgery, which affects its state and appearance thereafter. The degree of refractive error after surgery also plays a major role in patient satisfaction, meaning that if 20/20 vision (or at least 20/40, the legal vision for driving in the United States) is not achieved, the difference in prescription from before the surgery, and the strength required for current correction. Tear-production rate and tear quality is another variable, as is patient age and original expectations.

Occurrence of Enhancements

• AllAboutVision.com reports that it is difficult to accurately state the percentage of patients who need enhancement procedures after the initial LASIK procedure. Studies show a range from fewer than 5 percent to upward of 15 percent, based on the satisfaction variables. AllAboutVision.com states that enhancement is more likely for high degrees of farsightedness in people who are older than 50.

Visual Correction Enhancements

• Sometimes, often in the case of nearsightedness (technically called myopia), the vision improvement from the initial LASIK procedure seems inadequate. This is because the corneal tissue that needed removal and/or adjustment was not altered enough by the surgeon, and therefore an enhancement procedure is needed to further improve the patient's vision. The surgeon approaches this in the same manner as the first LASIK procedure, without increasing potential risks or complications.

Flap Repair

• During the initial LASIK surgery, the surgeon creates a flap on the cornea with either a special blade technology or a laser, beneath which she works on the corneal tissue. Once the surgeon's work on the corneal tissue is complete, the flap is closed, and the procedure is complete. However, the creation or closing of the flap can produce complications. If the flap is too thin, thick or wrinkled, the patient's vision will be affected with blurriness, haziness, multiple-image vision, ghost-like visions, floaters or some other condition that requires an enhancement procedure to readjust the corneal flap.

Similarities and Differences

• A LASIK enhancement procedure is almost identical to the original LASIK procedure, according to AllAboutVision.com, except that in the enhancement procedure, instead of creating a corneal flap, the surgeon relifts the same flap created during the first procedure. The same post-surgery protocol is instructed as that of the initial surgery.

Cost

• AllAboutVision.com reports that the majority of reputable surgeons do not charge an additional fee for enhancement procedures that occur within one year of the first LASIK procedure (if it is the same surgeon for both procedures). A fee is only likely if the second surgery happens after a specific period of time, like a year, or if the enhancement procedure is performed by a different surgeon from a different surgeon's office. Because an enhancement procedure is a possibility with LASIK surgery, be sure to ask the surgeon about these policies and fees.

Considerations

• Fluctuating vision is common after LASIK surgery, and doctors will follow up with the patient after a few days, a week, a month, and more or less frequently in between, depending on the patient's condition. If the patient experiences fluctuating vision within the first three months, doctors reporting for AllAboutVision.com say that this is not necessarily indicative of the need for enhancement surgery. However, if the vision gets blurry and still fluctuates after the post-surgery three-month mark, an enhancement procedure is likely necessary.