LASIK Enhancement
Over 1 million Americans undergo LASIK (laser-assisted in situ keratomileusis) each year, and the procedure is quite successful. A worldwide study by the American Society of Cataract and Refractive Surgery showed 95 % patients had satisfactory new vision after LASIK. About 86% of 16,000 U.S. Army personnel achieved 20/20 vision, with 98% achieving 20/40 or better. However, LASIK surgery can lead to complications in some cases. Common complications include double vision, dry eye, flap dislocation and night vision difficulties. Patients may experience glare, halos, and ghost images, particularly at night or in dim conditions. These patients are ideal candidates for laser re-treatment requiring a LASIK enhancement procedure. Patients with high refractory errors including ones' with diabetic retinopathy, not responding to LASIK, are considered for LASIK enhancement. LASIK Enhancement surgeries can also be performed to improve eyesight after refractive procedures other than LASIK, e.g after phakic intraocular lens implantation and refractive lens exchange. LASIK enhancement also helps eliminate residual refractive errors and sharpen vision after cataract surgery. Dry eye symptoms and tear functions are not compromised after LASIK enhancement.
Studies show LASIK enhancement rates mostly range between 5-15 %. Need for LASIK enhancement rates are higher for those having higher refractive error, including the ones with diabetic retinopathy, or in old age patients (>50 y). But treatment with LASIK Enhancement should be only considered after the vision gets stabilizes and does not shows further improvement. This is usually 2-3 months after original LASIK. Patients with diabetes have compromised healing and Recovery, and hence have more chances of needing laser enhancement.
LASIK enhancement is nearly identical to primary LASIK procedure. It can be performed either by lifting the corneal flap and applying additional laser to the corneal bed or by creating a new corneal flap. Lifting the original flap is safer as it does not require any additional incision. But it is often uncomfortable postoperatively and there is increased risk of epithelial in growth. Creating a new corneal flap is more comfortable to the patient. However, it can lead to creation of a free piece (wedge) of corneal flap tissue leading to corneal irregularity or peripheral scarring. The decision to choose the procedure also depends on many other factors and is best taken by the operating surgeon.
In most cases, single LASIK Enhancement is sufficient. But more than one enhancement may be required in difficult cases. Both techniques are performed on outpatient basis and take only five to fifteen minutes to complete. The patient may feel some pressure sensation but both procedures are painless. Post operatively, precautions are similar to LASIK and prophylaxis for eye infections is quite important for best outcomes.
