Okay, so you had LASIK done a few years ago and it was great at the start but now it’s getting a little less great. Because you read our Can LASIK Last Forever article, you suspect you are experiencing regression, the return of a spectacle prescription after having had previous refractive surgery due to natural changes of the eye over time. You book in with your eye surgeon, who is impressed with your knowledge of regression, and then wait patiently to hear what your options are for restoring the crystal-clear vision you had a few years ago.
Can I Get LASIK Done Twice?
Yes, it is possible to have LASIK done more than once. These situations may be referred to as an enhancement procedure or retreatment. In addition to addressing regression after a successful initial laser eye surgery procedure, retreatment can be done to fix up over- or under-correction from the first surgery.
There is technically no time limit on when you can have a second LASIK procedure. The retreatment is expected to produce results just as good even if performed a decade or two after the first treatment. However, if you’re now experiencing that wonderful age-related decline of your near focusing ability known as presbyopia, you may want to consider refractive surgery options other than conventional LASIK.
Is it Safe to Get LASIK a Second Time?
There is nothing inherently dangerous about having a LASIK retreatment provided your eye surgeon knows what they’re doing and you’ve gone through the proper assessment to ensure your eyes are suitable for a second round. Even if you were eligible for LASIK the first time, it may be a different story years later.
Corneal thickness
This is the predominant consideration when thinking about having LASIK done again. LASIK eye surgery is based on removing tissue from carefully calculated areas of your cornea, that clear dome of tissue at the front of the eye, to modify its shape. This results in a thinner cornea, though your surgeon would have ensured there was enough tissue to begin with before performing the first operation. To have retreatment with LASIK, you will again need to have a minimum corneal thickness for the second operation to be safe. If too much tissue is removed from repeat LASIK procedures, it will compromise the structure and integrity of your corneas and ultimately compromise your vision, too.
Stable vision
Similar to when you had your first LASIK eye surgery, your surgeon needs to see that your prescription has been stable for some time before doing another round of laser eye surgery. There’s no point in calculating your current prescription and correcting it with a laser if it’s only going to shift again in a few months. Different eye surgeons may have differing preferences on how long your prescription needs to be stable for, but most will require at least 12 months.
Eye health
Face it, things change with age. Your eyes might have bright and happy when you first had LASIK in your 20s but now you’re in your 30s and feeling the effects of dry eye more often than not. As LASIK and other laser eye surgeries are known to increase the risk of dry eye syndrome, having pre-existing dry eye symptoms could be a reason to avoid having LASIK retreatment. Other eye conditions that may mean you need to rethink having an enhancement procedure include past corneal infections, corneal trauma and scarring, keratoconus and other corneal degenerations, or cataracts.
General health
Autoimmune disorders can be a contraindication for LASIK as it increases the risk of infection and post-op dry eye. However, many LASIK surgeons nowadays are reporting good results in people with autoimmune disease, but each case will need to be individually assessed. Poorly controlled diabetes increases the risk of complications with LASIK, and people with a condition that results in poor wound healing, such as HIV or other immunocompromised states, should also avoid laser eye surgery. If you are pregnant, breastfeeding, or undergoing other hormonal changes, your surgeon will most likely advise you to delay your retreatment.
Alternatives to LASIK
As you can tell, being suitable for LASIK the first time around doesn’t automatically guarantee you’ll be eligible for LASIK retreatment. If this is the case, you do have other options.
If your corneas are too thin to make it through another round of LASIK eye surgery, you can consider:
- Photorefractive keratectomy (PRK): this is another method of laser eye surgery that can be safely performed on thinner corneas compared to LASIK
- Small incision lenticule extraction (SMILE): a minimally-invasive, newer technique of refractive surgery that involves extracting a thin sliver of tissue from the deeper corneal layers, meaning less overall corneal thickness is required
Refractive lens exchange (RLE) is an option for those whose corneas aren’t suitable for refractive surgery on the corneas, such as those with very thin corneas or dry eye problems. In this procedure, your eye’s natural lens is replaced with a lens implant calculated to correct for your prescription, like wearing a permanent contact lens inside your eye. The downside is that this also affects your ability to focus at near. Although there are ways around this, such as choosing a multifocal or extended depth of focus intraocular lens, you will need to have a good chat with your eye surgeon to find out whether it’s a sensible option for you, your eyes, and your lifestyle.