Things used to be great. But now you are back into glasses after lasik. Of course you would rather be out of the glasses (that’s why you got lasik done in the first place). So let’s look at how that’s done.
Lasik can be touched-up or enhanced. This is most frequently done by lifting up the lasik flap and performing another treatment OR by doing a PRK treatment instead. And in general, there aren’t a whole lot of restrictions on when or how many times this can be done.
“In general" is very broad though. You of course wouldn’t want to get a lasik touch up every month. How come? Read on.
When A Touch Up Is Beneficial
Lasik is very accurate. With good surgeons, techniques and equipment, less than 0.5% may need a lasik touch up enhancement within the first few years out after the procedure.
Beyond that, only natural changes within the eye will effect how long the lasik treatment lasts.
Learn more about Why Does Lasik Wear Off For Some
But some people will get a little more nearsighted over time. And if this happens, your vision will get blurry and you could get back into glasses.
And so this is the purpose of a lasik touch up enhancement. Whether you have a little bit of prescription left over after lasik or whether you became a little more nearsighted over time, this extra prescription can be treated.
How Long After Lasik
When we look at who can benefit from a lasik enhancement, it is a broad range of individuals. It includes those who may have just had lasik a few months ago (as soon as the prescription stabilizes; usually 3-6 months). It also includes individuals who may have had lasik 10 years ago or more.
And both groups can get a lasik touch up enhancement! (But as we’ll see later on, the way this is done can differ between these two groups).
There is really no limit to how long after lasik you can have a touch up enhancement.
“Exception"
No, I’m not immediately contradicting my last sentence. There is no limit on how long afterwards lasik can be enhanced; however, there is a limit on whether a lasik touch up enhancement can actually meet your vision needs.
For example:
- If you have developed blurry vision from cataracts in your eyes, doing a lasik touch up enhancement won’t be able to fix that. The touch up would be able to correct the prescription of the eye, but wouldn’t be able to fix the cataracts. Cataract surgery would be needed for that.
The cataract example is a little more obvious. But here is one more subtle example:
When we are young and get lasik, our vision is entirely corrected. We can see great looking far away in the distance as well as see up close. As we get a little older, however, it becomes harder to see up close. During our forties, the natural lens inside our eye becomes weaker. As this lens gets weaker, it has a harder time allowing us to focus up close. This process is called presbyopia.
Presbyopia can put you back into glasses after lasik - even without your prescription actually changing. You’ll be forced to use reading glasses to see up close.
Doing a lasik touch up enhancement can fix this and get you out of reading glasses, but it requires using a technique called monovision. One eye is corrected for distance vision while the other eye is corrected for reading vision. Read more about Everything To Know About Monovision Lasik.
Note: if you aren’t in reading glasses by the end of your forties, chances are you developed a little bit of nearsighted prescription allowing you to read; but you may also see things a little more blurry off in the distance. Having a lasik touch up enhancement without monovision to sharpen up your distance vision WILL cause your up close vision to become blurry.
How It’s Done
There are two main ways a lasik touch up enhancement can be done.
Lifting up the lasik flap
During the initial lasik, a corneal flap is created and folded back to do the lasik treatment. This flap is then replaced and allowed to heal up.
But this lasik flap can be re-lifted and re-folded back to do a re-treatment touch up procedure.
Pros
- Allows for a very similar quick recovery as the initial lasik procedure.
Cons
- There is an additional risk that the “skin" called epithelium on the surface of the cornea can grow underneath the lasik flap. This is called epithelial ingrowth. This extra growth of epithelium can be removed, but it requires additional procedures.
- When done within the first few years out after the initial lasik procedure, the risk of developing this extra growth of epithelium under the lasik flap can be 1% or less. This risk increases considerably the further out you are.
- This risk also increases if the lasik flap was created with a blade instead of a laser
Given the quick recovery, surgeons frequently prefer to lift up the lasik flap whenever a touch up is needed shortly after lasik.
PRK
Instead of messing with the lasik flap, the enhancement treatment can be done by treating the surface of the eye directly. This is done through a procedure called PRK.
Pros
- Avoids any flap issues as well as any risk of epithelial ingrowth.
Cons
- Has a much longer recovery time than lasik. During the first 5 days out after PRK, the eye will probably be uncomfortable and the vision will be blurry. It can take a little longer for the vision to reach 100%. See also How Long You Will Have Blurry Vision After PRK
Because of the longer recovery with PRK, surgeons generally prefer to reserve the use of this lasik touch up enhancement technique when the risks of lifting the lasik flap are higher - such as longer out after the initial procedure (especially if the original lasik procedure was done using the blade).
When A Lasik Touch Up CAN’T Be Done
As mentioned, there aren’t many restrictions that can prevent you from having a lasik touch up. But there are some. Here is what can prohibit you from being able to get a lasik touch up enhancement.
- Each laser eye treatment removes a small amount of cornea tissue (microns). If you remove too much of the cornea, the cornea can become weak. A weak cornea can change shape and blur vision - a condition called post-lasik ectasia. To reduce this chance as much as possible, many surgeons will make sure that 60% of the cornea thickness remains untouched. If you had a high prescription and / or a thin cornea for your first lasik treatment, you may not have enough cornea for a lasik touch up enhancement. But most will. Of note, another pro of the PRK ehancement is that it may be used even if you don’t have enough cornea thickness to lift the lasik flap and treat (since the PRK enhancement treats through the “already altered" lasik flap).
- On that note, if you did develop post-lasik ectasia, it’s important to instead make the cornea strong again through a procedure called corneal cross linking.
- Similar to becoming too thin, the cornea can also have too extreme of a change in shape. For instance, it is often optimal to avoid making the cornea too steep after laser eye surgery. This can become important for those requiring lasik to treat a farsighted prescription and needing an enhancement.
- Finally, when considering an touch up enhancement, it is again important to make sure that the prescription is stable and the eye is healthy. All similar requirements before the initial lasik procedure. Learn more at Learn Exactly Who Should Not Have Laser Eye Surgery
Summary
If you do end up with a small prescription after lasik and back into glasses, fear not, a lasik touch up enhancement can usually take care of that prescription. And there is really no limit on how long after lasik an enhancement can be done. There are just different techniques.
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