Enhancement should be avoided when safety parameters are not satisfied.
Contraindications include:
- Unstable refraction
- Thin residual stromal bed
- Abnormal corneal topography
- Keratoconus or forme fruste keratoconus
- Significant untreated ocular surface disease
Post-LASIK ectasia is rare but associated with inadequate screening and insufficient residual stromal thickness¹ ².
Dry eye disease should be treated prior to considering enhancement. Ocular surface instability can mimic residual refractive error. Evidence confirms optimisation of tear film improves refractive accuracy³.
Enhancement is elective. It should never be undertaken to “chase perfection” at the expense of safety.
Refractive surgery prioritises:
- Structural integrity
- Optical stability
- Surface health
- Visual quality
Only when all four are satisfied should enhancement proceed.
Conservative decision-making protects long-term vision.
References
- Randleman JB, Woodward M, Lynn MJ, Stulting RD. Risk assessment for ectasia after LASIK. Ophthalmology. 2008;115(1):37-50.
- Binder PS. Analysis of ectasia after LASIK. J Cataract Refract Surg. 2007;33(9):1530-1538.
- De Paiva CS, Pflugfelder SC. Management of dry eye after refractive surgery. Curr Opin Ophthalmol. 2004;15(4):299-303.
Related Topics
- Does an Enhancement After Laser or Lens Replacement Surgery Mean Something Went Wrong?
- What Is a Laser Eye Surgery Enhancement?
- How Common Is Enhancement After LASIK?
- Why Are Higher Prescriptions More Likely to Require Enhancement?
- Why Do Hyperopic Laser Treatments Regress More Frequently?
- Why Is Residual Hyperopia After Lens Surgery Different?
- How Is LASIK Enhancement Performed?
- How Is Enhancement Performed After SMILE?
- What Is Residual Stromal Bed and Why Does It Matter?
- Can Enhancement Affect Night Vision or Optical Quality?
- When Should Enhancement Not Be Performed?
- How Long Should You Wait Before Laser Enhancement?
- What Causes Regression After Laser Eye Surgery?
- What Is Topography-Guided Enhancement?
- Can Enhancement Increase Glare or Halos?
- Why Does Astigmatism Sometimes Remain After Laser Eye Surgery?
- What Is Epithelial Remodelling and Why Does It Matter?
- Is Enhancement Safer Than Intraocular Lens Exchange?
- What Is the Risk of Ectasia After Enhancement?
- Does Enhancement Affect Long-Term Vision Quality?
- What Does an Enhancement Cost?
