Laser eye surgery, also known as refractive surgery, has become a popular option for individuals seeking to correct their vision and ditch their glasses or contact lenses. LASIK (laser-assisted in situ keratomileusis) is one of the most common types of laser eye surgery, permanently reshaping the cornea to achieve clear vision. But what happens if you’ve already undergone LASIK and your vision isn’t quite what it used to be? Can you have laser eye surgery twice?
The Short Answer: Yes, But With Conditions
The good news is that, yes, in many cases, you can undergo laser eye surgery twice. This is often referred to as a second laser eye procedure, enhancement surgery, repeat surgery, or secondary surgery. However, it’s not as simple as scheduling a second LASIK procedure, for example. Several factors influence whether you’re a suitable candidate for a second procedure.
Reasons Why People Get Laser Eye Surgery Twice
While laser eye surgery treatments like LASIK eye surgery enjoy a well-deserved reputation for delivering exceptional results and achieving a high degree of patient satisfaction, there are situations where a second procedure might be necessary.
Here, we delve deeper into the two main reasons why someone might consider revisiting laser eye surgery:
Undercorrection Or Overcorrection During The Initial Procedure
In some cases, the initial eye surgery might not fully correct the patient’s refractive error. This can manifest in a few ways usually apparent in visual acuity:
1. Residual Nearsightedness (Myopia)
If the cornea isn’t reshaped enough during the first surgery, some degree of nearsightedness might persist. This can lead to the need for glasses for distance vision, particularly for activities like driving at night or watching movies.
2. Residual Farsightedness (Hyperopia)
Conversely, if too much corneal tissue is ablated during LASIK, it can lead to residual farsightedness. This can make it difficult to focus on near objects like reading materials or using electronic devices comfortably.
3. Incomplete Astigmatism Correction
Astigmatism is a refractive error that causes blurred vision at all distances. While LASIK is highly effective in correcting astigmatism, there’s a chance that some residual astigmatism might remain after the initial surgery. This can result in distorted or blurry vision.
These residual refractive errors can be frustrating for patients who underwent LASIK with the expectation of achieving complete spectacle independence. Fortunately, these issues can be addressed effectively in many cases with a second, minimally invasive laser procedure known as enhancement surgery. This procedure utilises the same principles as LASIK but refines the initial correction to achieve optimal visual outcomes.
Natural Ageing Process And Presbyopia
Our eyes are remarkable organs, constantly adapting and focusing to provide clear vision. However, as we age, certain physiological changes can affect our ability to see clearly, particularly at close distances.
Most people begin to experience a condition called presbyopia around the age of 40. This age-related decline in the eye’s ability to focus on near objects is a natural consequence of the stiffening of the crystalline lens within the eye. Presbyopia is not a side effect of laser eye surgery; it’s an independent process everyone experiences with advancing age.
For individuals who have undergone laser eye treatments and subsequently develop presbyopia, the inability to focus on near objects like reading materials or using smartphones can be a significant inconvenience.
While laser eye surgeries correct refractive errors like nearsightedness, farsightedness, and astigmatism, they don’t address the focusing mechanism responsible for near vision.
What To Expect: First LASIK Surgery Vs. Secondary LASIK Surgery
The experience of undergoing LASIK surgery can vary depending on whether it’s your first time or a revisit to address lingering vision issues. Let’s delve into the key differences in what to expect for each scenario:
Initial LASIK Procedure
The initial LASIK procedure is a multi-step process designed to reshape the cornea and achieve clear vision. Here, we’ll explore each step in detail, providing you with a clear understanding of what to expect during your LASIK experience:
1. Pre-Operative Consultation
A complete evaluation of your overall eye health, including tear production and any pre-existing conditions, is also conducted. During this consultation, the surgeon will discuss your refractive error and desired outcomes and answer any questions you may have.
Based on the evaluation, they will determine if LASIK is the most suitable option for you and discuss alternative procedures if necessary.
2. The LASIK Procedure
LASIK is a relatively quick and cosy outpatient procedure. Advancements in laser technology have made it a highly precise and sophisticated intervention. Typically, a femtosecond laser is used to create a thin, precise corneal flap on the surface of the eye.
This flap is then carefully lifted, allowing access to the underlying corneal tissue. A high-precision excimer laser then reshapes the corneal tissue according to your specific refractive error.
Once the reshaping is complete, the corneal flap is gently repositioned and adheres naturally without sutures. The entire procedure typically takes less than 30 minutes per eye.
3. Recovery
Following LASIK, it’s normal to experience some temporary discomfort, such as dryness, irritation, and blurry vision. These are usually manageable with medication prescribed by your ophthalmologist. Most patients notice significant vision improvement within the first few days, with continued improvement over a few weeks.
It’s crucial to adhere to post-operative instructions provided by your surgeon, including using prescribed eye drops and avoiding strenuous activities that could potentially dislodge the corneal flap.
Regular follow-up appointments with your ophthalmologist are essential to monitor healing and ensure optimal outcomes.
Second Laser Eye Surgery
While LASIK is a highly successful procedure, there can be situations where a second laser eye surgery might be necessary. This section will explore what to expect when revisiting laser vision correction.
1. Evaluation
The pre-operative assessment becomes even more critical for a second procedure. The surgeon will meticulously examine your eyes, paying particular attention to the stability and integrity of the corneal flap created during the first LASIK surgery.
They will also assess the remaining corneal thickness, which is vital in determining the suitability and safety of a second procedure.
A detailed discussion will be conducted regarding the reason for the second surgery, your current vision, and your expectations. The surgeon will explain a repeat procedure’s potential risks and benefits and ensure you understand all available options.
2. The Second Procedure
Different techniques might be employed depending on the reason for the second surgery.
For undercorrection or overcorrection from the initial LASIK, enhancement surgery with a high-precision laser may be used. This minimally invasive procedure refines the initial correction to achieve optimal visual outcomes.
If you experience presbyopia after LASIK, other laser vision correction procedures specifically designed to address near vision issues might be an option. Procedures for this issue use laser technology to create specific zones within the cornea that enhance near-focusing ability.
3. Recovery
The healing process after a second laser eye surgery is generally similar to the first procedure. You can expect some temporary discomfort and blurry vision, which will gradually improve over a few weeks. Following your surgeon’s post-operative instructions and attending scheduled follow-up appointments are crucial for optimal healing and successful outcomes.
Frequently Asked Questions (FAQs)
How long do I need to wait before having laser eye surgery for the second time?
There’s no set timeframe. Your ophthalmic surgeon will determine the appropriate waiting period based on your circumstances, including the stability of your vision from the first surgery and your corneal health.
Will I achieve perfect vision after a second laser eye surgery?
A second procedure aims to improve vision and reduce dependence on glasses or contact lenses. However, achieving a perfect 20/20 vision isn’t always guaranteed.
What if I develop presbyopia after LASIK?
Presbyopia is a natural age-related change, not a side effect of LASIK. There are laser vision correction procedures specifically designed to address presbyopia, but these are typically not performed as a second LASIK.
Can you wear glasses or contact lenses after a second laser eye surgery?
While the primary aim of a second laser eye surgery is to achieve clear vision without corrective lenses, it’s not always possible. Here’s a breakdown of the possibilities:
- Improved Vision Without Glasses:
- Partial Correction And Continued Lens Use: Depending on the reason for the second surgery and the results you achieved, you might still require glasses or contact lenses for some activities. For instance, if the goal was to address a minor under correction, you might only need glasses for specific tasks like driving at night.
The Final Word On Repeated Laser Eye Surgery
Laser eye surgery has transformed the lives of countless individuals, offering freedom from glasses and contact lenses. While LASIK boasts a high success rate, there are situations where a second procedure might be necessary. Remember, prioritising your eye health and making informed decisions based on a professional consultation are paramount when considering repeat laser eye surgery.
Contact Dr Edward Roufail, Melbourne, VIC, at (03) 9071 0180 to learn more about how you can navigate your second laser eye treatment smoothly!
Note: Surgical or invasive procedures carry inherent risks. As part of our standard practice, we thoroughly discuss these risks during the consent process before any surgical procedure. Your understanding and comfort are our utmost priority.
Sources:
Contreras, Juan M., et al. “Does Doctors’ Experience Matter in LASIK Surgeries?” Health Economics, vol. 20, no. 6, Mar. 2011, pp. 699–722. https://doi.org/10.1002/hec.1626.
Hu, Liang, et al. “Excimer Laser and Femtosecond Laser in Ophthalmology.” InTech eBooks, 2016, https://doi.org/10.5772/64238.
Mbbs, Karthik Kumar. “How Often Does LASIK Need to Be Redone? Repeat Surgery After 10 Years.” MedicineNet, 30 Dec. 2021, www.medicinenet.com/how_often_does_lasik_need_to_be_redone/article.htm.
Moshirfar, Majid, et al. “LASIK Enhancement: Clinical and Surgical Management.” Journal of Refractive Surgery, vol. 33, no. 2, Feb. 2017, pp. 116–27. https://doi.org/10.3928/1081597x-20161202-01.
“Quality of Vision and Patient Satisfaction After LASIK : Current Opinion in Ophthalmology.” LWW, journals.lww.com/co-ophthalmology/abstract/2004/08000/quality_of_vision_and_patient_satisfaction_after.9.aspx.
“What Should I Expect Before, During, and After Surgery?” U.S. Food And Drug Administration, 11 July 2018, www.fda.gov/medical-devices/lasik/what-should-i-expect-during-and-after-surgery.
“When and How to Perform LASIK and PRK Enhancements.” CRSToday, crstoday.com/articles/2013-oct/when-and-how-to-perform-lasik-and-prk-enhancements.
