LASEK Surgery After Previous Laser or Lens Surgery: Is It Possible?

If you’ve previously had LASIK, PRK, SMILE, or even lens surgery and are now noticing changes in your vision, it’s natural to wonder whether LASEK could be an option for you. Over time, prescriptions can shift slightly, vision may feel less sharp, or age-related changes can emerge that your original procedure didn’t fully correct. Many people assume that once they’ve had laser or lens surgery, further treatments are off the table but that isn’t necessarily the case. In fact, LASEK is often considered one of the safest enhancement options because it doesn’t involve creating or lifting a flap and can work well on eyes that have already been reshaped.

Why You Might Consider LASEK After Previous Eye Surgery

Even after successful eye surgery, some patients may notice small changes in their vision over time or wish for sharper, more precise clarity. Whether it’s due to natural ageing, residual prescription, or lifestyle needs, these changes are common and do not mean the original surgery was unsuccessful. In many cases, a LASEK enhancement procedure can help fine-tune vision, correct minor shifts, and improve visual quality. Before considering an enhancement, it’s essential to ensure that the cornea is fully healed and structurally safe for further treatment. A thorough evaluation by an experienced surgeon can determine whether LASEK is appropriate and what kind of improvement can realistically be achieved. This section explores the main reasons patients might consider LASEK after previous eye surgery and how enhancements can help maintain or refine visual outcomes.

There are several reasons why someone may need or want an enhancement procedure:

Prescription Regression: Even after a successful LASEK procedure, it is normal for vision to change slightly over time, a phenomenon often called prescription regression. This does not indicate a failure of the surgery but reflects natural changes in the eye, residual refractive errors, or personal visual needs. Many patients can benefit from a LASEK enhancement to fine-tune vision, but only after thorough evaluation to ensure the cornea is structurally safe for further treatment.

Natural Ageing: As we age, subtle changes occur in the structure of the eye. The cornea may slowly alter its curvature, and the lens inside the eye can become less flexible or slightly denser. These changes affect how light is focused on the retina, leading to gradual shifts in prescription. Even a perfectly executed LASEK procedure cannot stop these age-related optical changes, so minor fluctuations in clarity over the years are expected.

Residual Prescription: After the initial LASEK surgery, some patients may still have a small amount of short-sightedness, long-sightedness, or astigmatism remaining. This is especially common in patients with higher prescriptions before surgery. While functional vision is often achieved, the residual prescription can affect activities like night driving, reading fine print, or seeing long distances sharply. LASEK enhancement procedures can address these small refractive errors to further refine visual quality.

Desire for Sharper Results: Even when functional vision has been achieved, some patients wish for enhanced visual clarity sharper night vision, better contrast, or crisper long-distance vision. Lifestyle requirements, professional needs, or personal preference can make small improvements highly desirable. LASEK enhancements can target these refinements, provided the eyes are healthy and structurally sound.

Lens Surgery Adjustments: Patients who have undergone Refractive Lens Exchange (RLE) or cataract surgery may notice minor shifts in prescription over time. In such cases, LASEK can be used to fine-tune vision after lens-based procedures. However, the safety and thickness of the cornea must be carefully assessed to determine if an enhancement is appropriate.

Prescription regression is a natural and common phenomenon that can occur due to ageing, residual refractive errors, or changing visual needs. LASEK enhancements offer a safe and effective option to refine vision in these situations, but only after careful assessment to ensure the cornea is structurally healthy. Patients should have realistic expectations: while enhancements can improve clarity and sharpness, the procedure works best on eyes that have fully healed from the original surgery.

Why LASEK Is Often the Preferred Enhancement Option

For patients who have already undergone laser eye surgery, many surgeons recommend LASEK for enhancements because it avoids the risks and complications associated with corneal flaps. Unlike LASIK, which involves creating or lifting a flap in the cornea, LASEK works on the surface layer. This makes it particularly suitable for eyes that have already been reshaped, where flap manipulation could pose additional risks. By targeting the surface epithelium rather than altering deeper corneal layers, LASEK provides a safer, more controlled way to fine-tune vision without disturbing the integrity of the original procedure.

One of the main reasons LASEK is preferred for enhancements is that no flap lift is required. In patients who previously had LASIK, attempting to lift an old flap can lead to complications such as epithelial ingrowth, where cells grow underneath the flap; flap wrinkles, which can distort vision; flap dislocation; or overall weakening of the cornea, which can compromise long-term stability. LASEK eliminates these risks entirely because it works on the surface of the cornea, allowing surgeons to reshape the eye without disturbing any existing flap. This surface-based approach also allows for precise correction of residual prescriptions or small changes over time, making LASEK a reliable and predictable option for patients seeking enhancements after prior laser treatments. By avoiding flap-related complications, LASEK not only improves safety but also ensures that patients can achieve the best possible visual outcome while minimising the chances of post-operative issues.

Works Well After PRK and SMILE: Patients who have previously undergone PRK (Photorefractive Keratectomy) or SMILE (Small Incision Lenticule Extraction) may still be candidates for LASEK enhancements. Both PRK and SMILE are flap-free procedures, meaning the cornea’s structure is preserved without cutting a large flap, similar to LASEK. Because of this similarity, LASEK blends naturally with the cornea’s existing treatment pattern, allowing for safe and effective enhancements.

Preserves Corneal Strength: LASEK removes less corneal tissue than LASIK because it reshapes the surface rather than creating a flap. For patients who already have a slightly thinner cornea due to previous surgery, this is a major advantage. Preserving corneal strength is crucial for maintaining long-term eye health and reducing the risk of complications such as ectasia. This makes LASEK particularly suitable for patients needing fine-tuning after earlier refractive procedures.

Better for Minor Corrections: Enhancement procedures usually focus on small prescription changes rather than major vision corrections. LASEK excels in these situations because it allows precise, surface-level adjustments without the need for a flap. This makes it ideal for patients who are very close to their target vision but want to correct minor residual short-sightedness, long-sightedness, or astigmatism to achieve sharper clarity.

Lower Risk of Post-Op Dry Eyes: Previous eye surgeries can increase the likelihood of dry eyes due to corneal nerve disruption. LASEK is gentler on the corneal nerves compared with LASIK because it does not involve flap creation. This reduces the risk of post-operative dryness and discomfort, making the recovery process smoother and more comfortable for patients who have already had surgery.

Can You Have LASEK After LASIK?

Yes, in many cases, LASEK is regarded as the safest and most reliable enhancement option for patients who have previously undergone LASIK. Since LASEK works on the surface of the cornea rather than lifting or manipulating an existing flap, it avoids the potential complications that can arise from flap-based procedures, such as epithelial ingrowth, flap wrinkles, dislocation, or weakening of the corneal structure. This surface-based approach allows surgeons to precisely correct residual refractive errors or minor changes in prescription while maintaining the integrity of the original LASIK procedure.

Moreover, LASEK is particularly advantageous for patients whose corneas may have thinned slightly over time or for those who are at higher risk for flap-related issues. By avoiding flap manipulation, LASEK reduces the risk of long-term structural complications and provides a safer path to achieving stable, clear vision. Many surgeons prefer this method for enhancements because it combines safety with precision, offering predictable visual outcomes and minimal interference with the eye’s previously treated layers. Overall, for patients seeking a second procedure after LASIK, LASEK often represents the most prudent choice for both short-term recovery and long-term corneal health.

The key considerations are:

Corneal Thickness: After LASIK, the cornea is naturally thinner because tissue is removed during flap creation and reshaping. Before performing an enhancement, surgeons must ensure that enough corneal tissue remains, that the procedure won’t weaken the eye, and that the residual stromal bed is sufficient for safe correction. Advanced diagnostic tools such as corneal topography and tomography provide detailed maps of thickness, curvature, and overall corneal shape, allowing surgeons to carefully evaluate whether a surface procedure like LASEK can be performed safely.

Flap Integrity: If you’ve had LASIK, the corneal flap created during the first surgery remains for life. LASEK avoids cutting or disturbing this flap, which is one reason surgeons generally avoid repeating LASIK. Surface-based enhancements like LASEK are preferred because they reduce the risk of flap complications and maintain the structural integrity of the eye.

Prescription Size: LASEK enhancements are most suitable for small prescription regressions, typically in the range of -0.50 to -2.00 diopters. Minor shifts in short-sightedness, long-sightedness, or astigmatism can often be corrected effectively with LASEK, providing sharper vision without the need for more invasive procedures. Larger prescription changes may require alternative approaches, which your surgeon will discuss.

Healing Considerations: Some patients experience slower or slightly different healing after a second procedure because the cornea has already undergone previous surgery. Surgeons will evaluate your individual healing response and explain a realistic timeline for recovery. Expectations may include temporary fluctuations in clarity, mild discomfort, or gradual improvement over weeks to months.

When considering LASEK enhancement after LASIK, surgeons carefully evaluate corneal thickness, flap integrity, prescription size, and healing potential. LASEK is often the preferred choice for small regressions because it preserves corneal strength, avoids disturbing the LASIK flap, and provides precise, surface-level correction with a lower risk of complications.

Can You Have LASEK After PRK?

Yes, surgeons carefully evaluate each eye before proceeding with an enhancement to ensure it can be done safely and effectively. One reason LASEK is usually possible, even after previous procedures like PRK or LASIK, is that both PRK and LASEK are surface-based treatments, meaning they reshape the cornea without creating a flap. Since no flap is involved, the corneal biomechanics generally remain strong, reducing the risk of structural complications. This makes LASEK a reliable option for fine-tuning vision in patients who have already had surface procedures or even LASIK, provided the cornea meets safety requirements.

However, there are important considerations that surgeons take into account before moving forward. The epithelium may heal differently the second time around, so recovery can vary slightly from the initial procedure. The corneal surface must be carefully examined for haze or irregularities that could affect visual outcomes, and corneal thickness must still fall within safe limits to avoid weakening the eye. Many patients who had PRK years ago choose LASEK as a refinement option because it allows precise correction of residual prescription or minor changes in vision while maintaining corneal integrity and providing predictable, long-term results.

Can You Have LASEK After SMILE?

SMILE (Small Incision Lenticule Extraction) creates no flap, which makes LASEK one of the safest and most predictable enhancement options for patients who have previously undergone this procedure. Because there is no flap, the corneal structure remains largely intact, reducing the risk of weakening or other complications. Surface-based laser corrections like LASEK also blend well with the SMILE treatment, making it ideal for fine-tuning vision or addressing small prescription changes.

When considering LASEK after SMILE, surgeons carefully evaluate several key factors. Corneal thickness must be sufficient after the lenticule removal to ensure safety, and the corneal surface must be smooth enough to allow effective surface ablation. Additionally, surgeons assess dry eye levels, as surface procedures can temporarily exacerbate dryness. Thanks to these considerations and careful planning, enhancing vision after SMILE with LASEK is becoming an increasingly common and reliable option for achieving optimal visual outcomes.

Can You Have LASEK After Lens Surgery?

Why vision may need correction after lens surgery: Even after lens-based procedures, the implanted lens power may not be perfectly accurate, leaving some residual refractive errors. A small amount of astigmatism can also remain, affecting clarity in certain lighting or distances. Additionally, individual focusing preferences such as prioritising stronger distance vision can influence patient satisfaction with the initial outcome. LASEK provides a surface-based solution to address these subtle issues, fine-tuning the cornea to correct residual prescription errors, minor astigmatism, and personal visual preferences. This allows patients to achieve clearer, sharper, and more customised vision, making it an effective enhancement option after lens implantation procedures.

Why LASEK works well: LASEK is a safe and effective enhancement method for most patients following lens procedures because it does not interfere with the implanted internal lens. The adjustments are precise, targeting only the corneal surface to fine-tune vision without stressing the underlying corneal structure. By avoiding flap creation, LASEK eliminates the risk of flap-related complications, making it a predictable and low-risk option for improving residual refractive errors or minor visual imperfections after cataract surgery, RLE, or ICL implantation.

How Surgeons Assess Whether LASEK Is Safe After Previous Surgery

Not every patient is automatically a candidate for a second procedure, so careful evaluation is essential. Surgeons follow a thorough assessment process to determine whether LASEK can be performed safely, taking into account the specifics of the previous surgery and the current state of the eye. Advanced diagnostic tools, such as corneal topography, tomography, and epithelial mapping, provide detailed information about corneal thickness, shape, and structural integrity.

These assessments allow the surgeon to evaluate factors such as residual corneal tissue, surface smoothness, and tear film stability, all of which influence both safety and visual outcomes. By combining these objective measurements with a personalised review of the patient’s medical and surgical history, surgeons can determine whether a surface-based enhancement like LASEK is appropriate and plan the procedure to achieve precise, reliable results while minimising risk.

Corneal Thickness (Pachymetry): Corneal thickness, measured through pachymetry, is the most important factor when considering LASEK after previous surgery. Surgeons need to ensure that enough corneal tissue remains so that the enhancement can be performed safely without compromising the structural stability of the eye. If the cornea is too thin, attempting LASEK could weaken it and increase the risk of complications, in which case the procedure may not be recommended. Accurate measurement of corneal thickness helps surgeons determine whether a surface-based enhancement is feasible and safe.

Corneal Shape (Topography & Tomography): Corneal topography and tomography provide detailed maps of the cornea’s shape and curvature, which are essential for assessing suitability for LASEK after previous surgery. These scans help detect early signs of conditions like keratoconus, identify irregular astigmatism, and reveal any abnormalities caused by prior procedures. By evaluating these factors, surgeons can ensure that the cornea is strong, stable, and capable of safely undergoing a surface-based enhancement, reducing the risk of complications and improving the predictability of visual outcomes.

Residual Stromal Bed: The residual stromal bed refers to the layer of corneal tissue that remains beneath the surface after previous surgery. It plays a crucial role in determining how much additional laser correction can be safely applied during LASEK. Surgeons must adhere to strict safety thresholds for the residual stromal bed to prevent weakening of the cornea, maintain structural integrity, and minimise the risk of post-operative complications. Accurate assessment ensures that the enhancement is both safe and effective.

Epithelial Thickness Mapping: After previous surgery, the corneal epithelium may change by either thickening or thinning as it compensates for the altered corneal shape. Mapping the epithelium provides detailed information about these variations, allowing your surgeon to plan the LASEK treatment precisely. By understanding the epithelial profile, surgeons can customise the laser ablation to achieve smoother, more accurate corrections while minimising the risk of irregular healing or suboptimal visual outcomes.

Tear Film Quality: Tear film quality is a crucial factor when considering LASEK after previous surgeries, as dry eyes can become more pronounced with multiple procedures. Poor tear film can affect both comfort and visual outcomes, making accurate assessment essential. Surgeons perform careful testing to evaluate tear production, stability, and overall ocular surface health, ensuring that any dryness is managed appropriately before and after the enhancement to support optimal healing and clear vision.

Prescription Stability: Before performing LASEK after previous surgery, surgeons carefully evaluate the stability of your prescription. They check when your vision last changed, whether any shifts have stabilised, and whether the change is part of natural ageing. Enhancing vision on an unstable prescription can lead to suboptimal results or the need for further corrections, so only stable, consistent vision is considered suitable for treatment. This ensures the enhancement provides long-lasting, predictable outcomes.

Your Age and Lens Health: Age and the health of your natural lens are important considerations when evaluating LASEK after previous surgery. In older patients, mild lens opacities or early cataracts may be the actual cause of vision changes rather than issues with the prior procedure. In such cases, a corneal enhancement like LASEK might not address the underlying problem, and alternative treatments such as lens replacement may be more appropriate. Assessing lens clarity ensures that any enhancement is both safe and likely to provide meaningful visual improvement.

What the LASEK Enhancement Procedure Is Like

If your eye is deemed suitable for a LASEK enhancement, the procedure closely resembles a standard LASEK session, with some nuances to account for your previous surgery. The primary goal is to make precise adjustments to the cornea without compromising its structural integrity, ensuring the safest and most effective outcome. The procedure begins with the application of a topical numbing solution to ensure comfort throughout the treatment. Once the numbing takes effect, the surgeon carefully removes the corneal epithelium the thin outer layer of the cornea exposing the underlying tissue so the laser can reshape it accurately.

Next, a highly specialised excimer laser is used to reshape the cornea according to your personalised prescription. The laser removes microscopic amounts of tissue to correct residual refractive errors or minor changes in vision. Every step is meticulously controlled to preserve corneal strength while achieving the desired visual outcome. After the laser reshaping, the epithelium is gently repositioned over the treated area, protecting the newly shaped cornea and supporting natural healing. A protective contact lens is then placed as a bandage to reduce irritation and promote comfort during the early recovery phase.

Despite its precision, the entire enhancement procedure is typically quick, usually taking between 10 and 20 minutes per eye depending on the complexity of the correction. Although brief, every step is carefully performed to maximise safety and effectiveness. Many patients leave the clinic with minimal discomfort, ready to begin the recovery process, which is guided by post-operative care instructions to ensure the best possible visual outcome.

What to Expect During Recovery After Enhancement Surgery

Recovery after a LASEK enhancement generally follows a similar pattern to standard LASEK, though individual experiences may vary depending on your previous surgery. In the first few days, it’s common to experience blurry vision, light sensitivity, tearing, and mild discomfort as the epithelium heals. Using prescribed eye drops, resting your eyes, and wearing protective sunglasses can help manage these early symptoms and support the healing process. As healing progresses over the following weeks, vision gradually becomes clearer and more stable. Some patients notice fluctuations in clarity or minor haze, which is normal as the cornea remodels and the tear film stabilises. Full visual refinement typically occurs over several months, with most patients achieving sharp, stable vision within three to six months. Following your surgeon’s post-operative care instructions and attending all scheduled follow-up appointments are essential for optimising results and ensuring a smooth recovery.

You may experience: During the early stages of recovery after a LASEK enhancement, you may experience several common temporary symptoms. These often include a gritty or scratchy sensation in the eyes, heightened light sensitivity, excessive tearing, and initially blurry vision. These effects are a normal part of the healing process as the epithelium regenerates and the cornea adjusts to the laser treatment. Using prescribed eye drops, protecting your eyes from bright light, and following post-operative care instructions can help manage these symptoms and promote a smoother recovery.

Healing timeline:: The healing process after a LASEK enhancement is gradual and follows a predictable timeline. In the first 3–5 days, patients typically experience the most discomfort, including gritty sensations, light sensitivity, tearing, and blurry vision, as the epithelium begins to regenerate. By 1–2 weeks, vision usually starts to improve, becoming clearer and more functional for daily activities, though minor fluctuations may still occur. Between 1–3 months, the cornea continues to stabilise, and vision becomes increasingly consistent and reliable. Full visual refinement and long-term corneal remodelling, including collagen stabilisation, generally take place over 3–6 months. Following post-operative care instructions and attending follow-up appointments are essential for achieving the safest and most effective results.

Enhancement procedures after previous laser or lens surgery often heal slightly faster than the initial procedure because they typically involve smaller, more targeted corrections. Since the cornea requires less reshaping and the overall treatment is more precise, patients may experience a quicker reduction in discomfort and faster visual improvement. However, adherence to post-operative care and monitoring remains essential to ensure optimal healing and stable long-term results.

What Results Can You Expect?

Who Should NOT Have LASEK After Previous Surgery?

While LASEK enhancements can be highly effective, not every patient is a suitable candidate. Certain conditions can make the procedure unsafe or limit its potential benefits. For example, if your cornea is too thin, removing additional tissue could compromise its structural integrity. Early signs of ectasia a weakening or bulging of the cornea also make further surface ablation risky. Patients whose vision is still unstable, whether due to shifting prescriptions or ongoing changes after previous surgery, may not achieve predictable results. Severe dry eye syndrome can further complicate healing and reduce visual comfort, while the presence of cataract changes in the natural lens may mean the underlying issue isn’t corneal at all. Additionally, patients who expect perfect, “textbook” vision beyond what is realistically achievable may be disappointed, as enhancements are intended to refine vision rather than completely recreate it.

When LASEK is deemed unsuitable, surgeons will guide patients toward the safest and most effective alternatives based on their eye health and visual goals. Options may include PRK, another surface-based procedure that can fine-tune vision without a flap; ICL (implantable collamer lens) insertion, which corrects residual refractive errors from within the eye; or lens replacement procedures for those with early cataract changes. In some cases, the safest recommendation may be to avoid further treatment altogether, particularly if the potential risks outweigh the likely benefits. The overarching goal is always to prioritise the long-term health and stability of your eyes while achieving the best possible visual outcome.

Alternatives If LASEK Isn’t Suitable

While LASEK works well for many patients, it isn’t the best choice for everyone. Certain factors like having a thinner-than-average cornea, a history of previous eye surgeries, very high prescriptions, or specific anatomical considerations can make other procedures safer or more effective. Understanding that LASEK isn’t the only path to clear vision can help reduce anxiety and set realistic expectations. Knowing your alternatives allows you to make an informed decision with confidence, rather than feeling limited by a single option. Every patient’s eyes are unique, and what works perfectly for one person may not be ideal for another.

Several effective alternatives exist, each tailored to different needs and circumstances. PRK, a surface-based laser procedure, reshapes the cornea without creating a flap, making it suitable for eyes that require a gentler approach. Implantable Collamer Lenses (ICLs) are another option, offering excellent outcomes for patients with high prescriptions or thin corneas, and have the added benefit of being reversible. For older patients or those with early lens changes, Refractive Lens Exchange (RLE) replaces the natural lens with an artificial one, correcting both distance and near vision while addressing age-related changes. In select cases, a LASIK flap lift enhancement may be possible, allowing small corrections under an existing flap, though it carries slightly higher risks. Consulting a skilled surgeon ensures that your choice balances safety, effectiveness, and long-term stability, giving you the best chance of achieving clear, comfortable vision.

PRK:PRK is a surface laser technique similar to LASEK. Instead of creating a flap, the epithelium (outer layer of the cornea) is removed and the laser reshapes the underlying corneal tissue. This approach is often preferred when the cornea has already undergone previous surgery, is thinner than average, or when preserving flap integrity is important. PRK is effective for small to moderate prescription corrections and has a predictable healing process, although recovery is slightly slower than LASIK. LASEK is very similar to PRK, which makes it a natural choice for enhancements after PRK.

ICL (Implantable Lens): An Implantable Collamer Lens (ICL) is a small lens surgically inserted inside the eye, in front of the natural lens but behind the iris. ICLs are especially useful for patients who cannot undergo further laser reshaping due to thin corneas, irregular corneal topography, or high prescriptions. Unlike laser procedures, ICLs do not remove corneal tissue and can provide excellent visual outcomes for moderate to high refractive errors. They are also reversible, which makes them an option for patients seeking alternatives to corneal laser surgery.

RLE (Lens Replacement):RLE involves removing the eye’s natural lens and replacing it with an artificial intraocular lens (IOL). This procedure is best suited for older patients or those developing early cataracts. RLE can correct both distance and near vision and is especially useful when the cornea cannot safely undergo laser enhancements. It also addresses age-related lens changes that can affect clarity, making it a comprehensive solution for patients with both refractive errors and lens issues.

LASIK Flap Lift Enhancement: A LASIK flap lift enhancement involves carefully lifting the original flap created during the initial LASIK procedure to perform a small additional laser correction underneath. This approach is rarely used today because surface-based enhancements like LASEK or PRK are generally safer, especially for eyes with thinner corneas. It may be appropriate in select cases where the flap is stable, healthy, and free of complications, allowing precise correction of minor residual prescriptions. One advantage is faster visual recovery compared with surface procedures, but lifting the flap carries a slightly higher risk of complications, such as epithelial ingrowth or flap distortion, so it requires careful assessment and an experienced surgeon.

Your surgeon plays a crucial role in guiding you toward the safest and most effective enhancement option. By carefully evaluating your corneal health, prescription stability, tear film quality, and any changes from previous surgeries, they can recommend whether LASEK is suitable or if an alternative procedure would be safer. Their expertise ensures that the chosen method maximises visual improvement while minimising risks, giving you the best chance of a successful, long-term outcome.

FAQs:

1. Can I have LASEK after LASIK?
   Yes, many patients who have had LASIK can safely undergo LASEK as an enhancement. LASEK is a surface procedure, meaning it does not involve lifting the original flap created during LASIK. This reduces the risk of complications such as flap dislocation or epithelial ingrowth. Surgeons evaluate your corneal thickness, flap integrity, and the amount of residual tissue to ensure the procedure is safe and effective.
2. Is LASEK possible after PRK?
   LASEK can be performed after PRK, as both procedures are surface based. The cornea heals differently after a second surface ablation, so surgeons assess the epithelium and check for scarring or haze. Provided the corneal thickness is sufficient and the surface is healthy, LASEK can refine vision and correct minor prescription changes effectively.
3. Can LASEK enhance vision after SMILE?
   Yes, LASEK is often used to enhance vision after SMILE surgery. SMILE does not create a flap, which makes it compatible with LASEK. The cornea generally remains strong, and surface laser corrections like LASEK blend well with the previous lenticule removal. Surgeons examine corneal thickness and smoothness to ensure optimal results while minimising the risk of post-operative complications.
4. Can LASEK be done after lens surgery, such as cataract or RLE?
   LASEK can be safely performed after lens-based procedures, including cataract surgery, refractive lens exchange, or implantable collamer lens placement. The surface laser does not interfere with the internal lens, making fine-tuning of residual prescription or small astigmatism adjustments possible. Surgeons check the eye’s overall health and lens stability before proceeding to ensure the enhancement is safe.
5. How do surgeons determine if LASEK is safe after a previous procedure?
   Safety is determined through a detailed preoperative assessment. Surgeons measure corneal thickness, map the corneal shape, evaluate the residual stromal bed, and check epithelial thickness. They also assess tear film quality, prescription stability, and lens health. Only when all these factors indicate structural integrity and stability is the procedure considered safe.
6. What should I expect during a LASEK enhancement procedure?
   The process of a LASEK enhancement is similar to the standard procedure. Topical numbing drops are applied, the epithelium is gently removed, and a precise laser reshapes the cornea. The epithelium is then repositioned and a protective contact lens is placed. The procedure is usually quick, lasting about 10–20 minutes per eye, and most patients experience minimal discomfort during the treatment.
7. How long does it take to recover after a LASEK enhancement?
   Recovery after LASEK enhancement is comparable to initial LASEK procedures. Patients typically feel a gritty sensation and experience light sensitivity and watery eyes for the first few days. Blurry vision is common initially, with noticeable improvement within one to two weeks. Full visual stability and corneal healing generally occur within three to six months, though most fine-tuning results are evident sooner.
8. What kind of vision results can I expect?
   Most patients experience sharper, clearer vision after a LASEK enhancement. Night vision often improves, glare is reduced, and reading or distance clarity is refined. The procedure is aimed at enhancing or fine-tuning existing results rather than completely reinventing vision, so realistic expectations are important for patient satisfaction.
9. Who may not be suitable for LASEK after previous surgery?
   Patients with very thin corneas, unstable vision, significant dry eye, or signs of ectasia may not be suitable for a LASEK enhancement. Those with early lens changes or cataracts may also be advised to consider alternative procedures. Surgeons will carefully review each patient’s eye health and recommend the safest approach, which may involve PRK, ICL, lens replacement, or no further treatment.
10. What are the alternatives if LASEK isn’t recommended?
    When LASEK is not suitable, there are several alternatives. PRK is a surface procedure similar to LASEK and can be considered when the epithelium is better removed. Implantable collamer lenses provide an option for eyes that cannot undergo additional laser reshaping. Refractive lens exchange may be appropriate for older patients or those with developing cataracts. Rarely, LASIK flap lift enhancements are used if the previous flap remains stable and the cornea allows it.

Final Thought: LASEK After Previous Eye Surgery

If you’re considering a vision enhancement and want to explore your options, it’s important to consult with an experienced surgeon who can assess your unique situation. LASEK is often a safe and effective choice for patients who have previously undergone LASIK, PRK, SMILE, or lens surgery, but every eye is different, and personalised evaluation is key. If you’d like to find out whether Lasek surgery in London is suitable for you, feel free to contact us at Eye Clinic London to arrange a consultation and discuss the most appropriate approach for your eyes.

References:

1. Budoš, M., Seňová, M., Florez, I. & Stodulka, P. (2019) ‘Corneal biomechanical properties after SMILE versus FLEX, LASIK, LASEK or PRK: A systematic review and meta‑analysis’, BMC Ophthalmology, 19: 277. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6676534/
2. Netto, M. V. & Wilson, S. E. (2005) ‘Surface ablation (PRK or LASEK) as retreatment for residual ametropia after LASIK’, Journal of Refractive Surgery, 21(7 Suppl), pp. S801–S805. Available at: https://pubmed.ncbi.nlm.nih.gov/17662427/
3. Seiler, T., Quenzel, H., & Stefani, F. (2007) ‘LASEK versus PRK: comparatives outcomes and safety for myopia correction’, Journal of Cataract & Refractive Surgery, 33(7), pp. 1110–1119. Available at: https://pubmed.ncbi.nlm.nih.gov/12686232/
4. Moshirfar, M., Kramer, G. A., Myers, T. R., et al. (2022) ‘Photorefractive keratectomy (PRK) enhancement after small‑incision lenticule extraction (SMILE) for residual refractive error: one‑year outcomes’, Clinical Ophthalmology, 16, pp. 3719–3727. Available at: https://pubmed.ncbi.nlm.nih.gov/36119391/
5. Ganesh, S. & Gupta, S. (2022) ‘Clinical evaluation of corneal biomechanics following laser refractive surgery in myopic eyes: a review of the literature’, Journal of Clinical Medicine, 12(1):243. Available at: https://www.mdpi.com/2077-0383/12/1/243