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Enhancement refractive surgery is a euphemism for needing additional surgery to fine tune the result of the initial conventional
or custom wavefront Lasik, Bladeless Lasik, PRK, LASEK, or Epi-Lasik excimer laser assisted procedures.
Difficult Vision
It is more difficult
to accurately predict results with a large refractive error than with a small refractive change. Hyperopia (farsighted, longsighted) is more difficult to correct
than myopia (nearsighted, shortsighted), and astigmatism adds to the challenge. Also, we are talking about
microsurgery on human biological tissue. Sometimes things simply
don't go as planned.
Surgery Alternative
Before you have any additional surgery,
you should discuss with your doctor CLAPIKS. This is a technique that uses eye drops to make the
cornea more malleable and Rigid Gas Permeable (RGP) contact lenses
to reshape the cornea to correct minor overcorrection and undercorrection.
Waiting Time
Do not be in too
much of a hurry to have enhancement surgery. Fluctuations in vision
can last several months. You want to wait until your eyes have settled
down before having an enhancement. It is common for the eye to regress back toward the original refractive error. You don't want to have
additional surgery until the regression has resolved. Most enhancements
are performed between three and six months after the first surgery,
but can be performed earlier and much later. Discuss the probabilities
with your doctor before you proceed.
Greater Predictability
If you are needing enhancement surgery for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, LASEK, or Epi-Lasik, it is probable that most of the required refractive
error was corrected with the first surgery.
Since smaller changes
tend to be easier to accurately predict, you should be able to reasonably
expect a good outcome, however there are exceptions.
Hyperopia correction
and myopia correction are significantly different with different
techniques and different expected results. As a general rule, hyperopia
is more difficult to predictably correct than myopia (more).
If you were originally myopic and have been overcorrected into hyperopia,
you need to revisit the entire issue as if you were having surgery
for the first time. For the most part, you are having surgery for
the first time.
Flap Lift
If your initial surgery was Lasik or Bladeless Lasik, the doctor
will probably lift the existing flap. Although the Lasik flap does
heal (more), it
does not heal the same as a cut on your arm and the Lasik flap can
be lifted years after surgery. Well, "lifted" is probably not the
right term. It is more like separating the cornea at the location
of the original flap. Bladeless Lasik flaps tend to adhere more
firmly to the underlying stroma, but they too can normally be manipulated
and lifted. It is rare that a new flap must be created for enhancement.
Surface Ablation Techniques
If your initial procedure was PRK or LASEK, the epithelium will be manipulated during an enhancement surgery
just as it was with the initial surgery.
If your initial procedure was Epi-Lasik, you cannot have
Epi-Lasik for your enhancement. The epikeratome used to create the epithelial flap requires the Bowman's
layer for stability. During the initial surgery, the Bowman's
layer is ablated away. PRK or LASEK would be the most likely methods
for an Epi-Lasik enhancement.
Looking For Best Lasik Surgeon?
If you are ready to choose a doctor to be evaluated for conventional
or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization.
Locate a USAEyes Evaluated & Certified Lasik Doctor.
Personalized Answers
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