This page is for patients whose laser eye surgery result is not quite at the expected level, or who want to understand Blue Fin Vision®’s enhancement policy before proceeding with surgery.
What Triggers an Enhancement Assessment
Enhancement is considered when: residual refraction of more than 0.5D of sphere or cylinder persists at three months or later; regression has returned the prescription toward its pre-operative level; persistent night vision complaints, halos or glare, are present at six months and measurable aberrometric abnormality is identified; or the patient reports dissatisfaction with unaided vision that is corroborated by formal refraction.⁴
Enhancement is not offered until refraction is confirmed stable over two consecutive measurements. Enhancing an unstable prescription produces an unstable result. Patience is sometimes the first step.
The Enhancement Options
LASIK flap lift: for patients who had LASIK, the original flap can be lifted and re-treated for up to approximately ten years post-surgery. The flap re-adheres after re-treatment as it did after the original procedure. Recovery is similar to the primary LASIK experience.¹
PRK surface treatment: if the flap cannot be safely re-lifted, very thin flap, significant fibrosis, or if corneal thickness precludes flap re-lift, surface laser is applied directly. Recovery takes four weeks to functional vision, as with primary PRK.²
Blue Fin Vision®’s Enhancement Policy
Patients on the premium laser pathway at Blue Fin Vision® are covered by an enhancement policy: if a corneal touch-up is clinically indicated after primary laser surgery, the additional surgeon fee is removed.³ The policy covers residual refraction, regression, and persistent night vision complaints where wavefront-guided enhancement is appropriate. It does not cover refractive change attributable to natural ageing, presbyopia or cataract, which are addressed through separate procedures.
Who This Is Not For
Enhancement is not available immediately post-surgery, refraction must be stable for at least three months before enhancement is appropriate. It is not appropriate for patients whose visual dissatisfaction is related to dry eye, treating the dry eye first often resolves the complaint without further laser intervention. And it is not offered as a routine upgrade; enhancement is a clinical decision based on formal refraction, not patient preference for marginally better acuity in an already excellent outcome.
Clinical Perspective
At Blue Fin Vision®, the enhancement policy reflects a commitment to the outcome, not the procedure. A second treatment, if clinically indicated, is the practice’s responsibility, not an additional cost to the patient. This is the proof that Blue Fin Vision® is invested in what the patient sees, not just in what happens on the day of surgery.⁵
Clinical Takeaway
Enhancement is considered at Blue Fin Vision® when residual refraction exceeds 0.5D at three months or later, regression is confirmed, or persistent night vision complaints are measurable. Refraction must be stable before enhancement is offered. Patients on the premium laser pathway are covered by an enhancement policy, no additional surgeon fee for clinically indicated re-treatment.
References
- Gonvers M, Bornet C, Othenin-Girard P. Implantable contact lens for moderate to high myopia: relationship of vaulting to cataract formation. J Cataract Refract Surg. 2003;29(5):918–924.
- Sanders DR, Vukich JA. Incidence of lens opacities and clinically significant cataracts with the implantable contact lens: comparison of two lens designs. J Refract Surg. 2002;18(6):673–682.
- Taban M, Behrens A, Newcomb RL, Nobe MY, Saedi G, Sweet PM, McDonnell PJ. Acute endophthalmitis following cataract surgery: a systematic review of the literature. Arch Ophthalmol. 2005;123(5):613–620.
- Dougherty PJ, Rivera RP, Schneider D, Lane SS, Brown D, Vukich J. Improving accuracy of phakic intraocular lens sizing using high-frequency ultrasound biomicroscopy. J Cataract Refract Surg. 2011;37(1):13–18.
- Alfonso JF, Lisa C, Abdelhamid A, Montés-Micó R, Poo-López A, Ferrer-Blasco T. Three-year follow-up of subjective vault following myopic implantable collamer lens implantation. Graefes Arch Clin Exp Ophthalmol. 2010;248(7):1007–1012.
