LASIK, or Laser-Assisted In Situ Keratomileusis, is a surgical procedure that reshapes the cornea to improve how light focuses onto the retina. This corrects refractive errors like nearsightedness, farsightedness, and astigmatism, often reducing or eliminating the need for glasses or contact lenses. Since its FDA approval in the late 1990s, millions have undergone LASIK, making it one of the most frequently performed elective surgeries globally. While many achieve lasting vision correction after one procedure, questions often arise about undergoing LASIK more than once.
Understanding LASIK Retreatment
A LASIK retreatment, or “enhancement,” is a secondary procedure to refine vision if the initial outcome isn’t optimal or if changes occur over time. While LASIK aims for a one-time correction, some individuals experience a gradual vision decline years later, known as regression. This can be due to the eye’s natural healing or age-related changes.
Retreatment may also be considered for an initial undercorrection, meaning the refractive error was not fully corrected, or an overcorrection, where the eye was corrected beyond the target. While less common with technological advancements, these situations can occur. A single additional procedure is the most frequent scenario for enhancement. Approximately 1% to 2% require an enhancement within the first year, and about 5% over their lifetime. The decision for retreatment depends on the eye’s specific condition and capacity for further reshaping, not an arbitrary number of procedures.
Key Factors for Retreatment Eligibility
Eligibility for LASIK retreatment depends on several factors. The most significant is residual corneal thickness after the initial procedure. If the cornea is too thin from the first surgery, another procedure could compromise its structural integrity, leading to complications. Ophthalmologists measure this thickness to confirm sufficient tissue remains for a safe enhancement.
Overall eye health is also important. Conditions like severe dry eye, glaucoma, cataracts, or other progressive eye diseases can affect a second LASIK outcome. The refractive error must also be stable, meaning a patient’s prescription should not have changed significantly.
Finally, the integrity of the original LASIK flap is assessed. If the flap is damaged or unsuitable for relifting, it impacts the feasibility of a standard LASIK enhancement. These factors collectively limit how many times LASIK can be safely performed.
Alternatives When Retreatment Isn’t Possible
If LASIK retreatment is not possible, other vision correction options exist. One alternative is Photorefractive Keratectomy (PRK). Unlike LASIK, PRK does not create a corneal flap; instead, the outer corneal layer is removed, and the laser reshapes the surface directly. PRK is an option if residual corneal thickness is insufficient for another LASIK procedure, as it preserves more corneal tissue. While PRK’s recovery is longer than LASIK, final visual outcomes can be similar.
Another surgical option, especially for higher prescriptions or contraindications to further corneal ablation, is an Implantable Collamer Lens (ICL). These tiny, biocompatible lenses are placed inside the eye, typically behind the iris, correcting vision without removing corneal tissue. ICLs are reversible and do not permanently alter the cornea, making them suitable for those unable to undergo additional laser eye surgery. If surgical options are not advisable or desired, traditional corrective eyewear like glasses or contact lenses remains a solution.