Posted on December 30, 2017
Generally speaking, the outcome of laser eye surgery is permanent with more than 98%patients reporting much improved eyesight for years after surgery. Of the remaining patients, a few may require a second procedure, in case they do not want to wear even minor corrective lenses, for optimal vision correction.
This is called a LASIK enhancement or a LASIK touch up, and is a follow-up procedure performed if the primary vision correction surgery is unsatisfactory or if your vision changes significantly over time.
With the almost revolutionary changes in currently available LASIK technology, second surgeries are rarely required. The rate of retreatments among an experienced group of LASIK surgeons was reported to have declined from 4.5 percent in 2005 to less than 0.2 percent in 2012, which mean only two out of every thousand patients undergoing LASIK required a second surgery.
Do I need a second procedure after LASIK?
Do not panic if your vision is not perfect the day after surgery. That is not an indication for a repeat surgery. Your vision will slowly recover, to its optimum over the first few weeks, and this normal in certain patients.
A second surgery may be required soon after your initial surgery if the vision is blurred, or later in life if there have been significant changes to your vision over time. Your ophthalmologist will perform regular check ups in order to monitor your recovery for the first three to six months, and suggest a secondary procedure, if indicated.
A basic rule of thumb is that if your vision seems blurry even three months after LASIK, you may require an intervention. During follow up, if your vision is blurred, your treating eye surgeon will prescribe new eyeglasses until your vision improves and stabilizes. This is because side effects such as blurring of vision and sensitivity to light may persist for up to twelve weeks after LASIK, during recovery.
In the other scenario, you may have perfect vision for months to years after LASIK. But with age, your vision may change significantly. This is called regression, and you may experience and increased dependence on spectacles, and your doctor may consider a second laser surgery.
It is important to remember that almost everyone after the age of forty requires eyeglasses for reading, regardless of whether they have had LASIK or not. This is called presbyopia, and must not be confused with regression. The treatment of presbyopia is entirely different.
Do I need further tests again?
Yes, your doctor will need to perform all of the tests as for your first laser surgery, to determine your suitability for the LASIK enhancement. Most important of all, your eye doctor will re-evaluate your corneas to ensure that there is sufficient corneal thickness for a second surgery, since the LASIK enhancement also removes corneal tissue to reshape your cornea for eliminating the need for glasses.
If the residual corneal thickness is less than required, your doctor will discuss other refractive procedures such as PRK with you, which are better suited to your eyes and needs.
How is this surgery different from my first LASIK surgery?
The LASIK enhancement is not very unlike your first surgery. However, the enhancement does not require the creation of the corneal flap again. In fact your surgeon will use specially designed forceps to lift the flap which was created during the first surgery. He will then reshape your cornea using the laser which is controlled by a powerful computer, as for the first LASIK. Since only a minimal reshaping is required during a LASIK touch up the procedure is painless, and takes much less time.
After the procedure, your doctor will call you back for check ups as after the primary surgery, and prescribe eye drops and the same post-operative aftercare as before for best results.
Whether you need an enhancement or not, a yearly follow up with your treating eye doctor after LASIK is essential to ensure optimal eye health.
Other reasons for laser enhancement:
LASIK enhancement surgeries maybe be performed to improve vision after other refractive surgeries like, phakic IOL implantation and refractive lens exchange (RLE).
LASIK and PRK enhancements may be used after cataract surgery to eliminate residual refractive errors and eliminate dependence on glasses.
It is important to remember that with currently available state of the art technologies for eliminating the need for glasses, the second are rarely required, and most patients experience perfect after the first surgery itself. For the extremely small subgroup of patients who do not experience the delight and quality of life that LASIK promises, help is easily available. There are enough safe and effective options available to provide better sight without glasses or contact lenses.