Every patient and refractive
surgeon wants to achieve perfect vision correction with one
refractive surgery procedure. Unfortunately 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
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.
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.
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
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.
If you are needing enhancement surgery for conventional or custom
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.
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.
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.
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
used to create the epithelial flap requires the
layer for stability. During the initial surgery, the Bowman's
ablated away. PRK or LASEK would be the most likely methods
for an Epi-Lasik enhancement.
If you are ready
to choose a doctor to be evaluated for Lasik or any refractive
surgery procedure, we highly recommend you consider a doctor who
has been evaluated and certified by the USAEyes nonprofit
Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery