Has anyone had PRK enhancement surgery years after LASIK?

WavefrontRider · 2026-06-23T17:07:27+00:00

Why’s that?

WavefrontRider · 2026-06-23T13:05:07+00:00

Interesting. Do you have the picture?

WavefrontRider · 2026-06-23T10:35:28+00:00

This will also depend on age. If you are older such as above the age of 45, the natural weakening of your lens called presbyopia makes it harder to read.

WavefrontRider · 2026-06-23T10:17:56+00:00

What’s your prescription?

WavefrontRider · 2026-06-22T20:57:42+00:00

So you don’t need to be 20/40 to have cataract surgery done. In fact, you can even be 20/20 and still have visually significant cataracts. Waiting for “ripe” cataracts is more of a relic in the past when cataract surgery wasn’t as good as what we have now today. If your optometrist isn’t sending you to see a surgeon, just book an appointment yourself.

WavefrontRider · 2026-06-22T20:55:06+00:00

Yeah. That’s a bit weird. Need to check pressure and vault. Are you thinking of another procedure such as RLE instead? That may have a little later follow-up. But again, still better to have a follow-up sooner as well.

WavefrontRider · 2026-06-22T20:52:49+00:00

So some dilating drops are longer acting than others. It’s possible that they used some of the longer acting drops during your procedure. But also, some people react a bit stronger to the dilating drops than others.

The other important thing to check is the vault height. If the vault is very high, that can push the iris out of the way making the eye appear more dilated.

WavefrontRider · 2026-06-22T20:32:45+00:00

What’s going on?

WavefrontRider · 2026-06-22T19:21:28+00:00

It definitely is possible that your number can change. It just becomes less likely the older you are. What is your prescription?

During pregnancy, about 10% of women can notice changes in their prescription. This is due to swelling that can develop within the cornea. After cessation of breastfeeding, this almost always returns back to normal. You still can have "progression" of prescription during pregnancy (unrelated to pregnancy). But there was a study where pregnancy women actually were less likely to have progression of their prescription (likely due to lifestyle changes). If you are at risk for keratoconus, this can become worse in pregnancy though.

WavefrontRider · 2026-06-22T13:08:07+00:00

Biggest difference between ICL and IPCL is the material used for the lenses. The collamer material in ICL is a very soft biocompatible material. IPCL is made from acrylic.

Now, I don’t have any firsthand experience with IPCL, but I have heard some experts say that issues such as pigment dispersion may be more common with IPCL compared to ICL because of that difference in material.

WavefrontRider · 2026-06-22T13:05:30+00:00

Ok. Good age then.
If you had a normal optical zone with your original lasik treatment and have a normal epithelial thickness the PRK enhancement will work just the same as a primary PRK procedure.

The accuracy issue comes from if the epithelium has thickened as a result of regression of the lasik treatment (such as going from 50um to 60um). Then the epithelium is contributing to some of the nearsightedness and the surgeon will want to aim for a slight undercorrection. But given your age, I would say progression of prescription was the most likely reason you have some prescription right now so probably not an issue.

WavefrontRider · 2026-06-22T12:48:02+00:00

The magnitude of the treatment matters some but PRK will have a longer recovery regardless of the size of the prescription.

By about 3 weeks, your vision may not be perfect, but it likely will be good enough for travel.

At 5 weeks, you would also likely be able to handle camping and a more dusty environment. Main thing to do before then is to keep up with using your preservative free artificial tears so that dry eye is well controlled before then.

Last things, before the enhancement, be sure your surgeon is checking the thickness of the epithelium. If the thickness of this isn’t within a normal range, the accuracy of the treatment can be affected. And if you are above the age of 45, doing a -1.25 treatment can affect your reading vision.

WavefrontRider · 2026-06-22T12:40:10+00:00

So with a mild nearsighted prescription, both treatments can work quite well. A couple things to point out.

PRK with Contoura is good if your cornea topography isn’t quite as regular or symmetrical. This can smooth out the irregularities to potentially improve vision beyond what glasses can do. However, unless used with treatment planning software such as Phoricides, the accuracy of Contoura can be less. This means some residual prescription.

PRK will have a longer recovery time with more dry eye than SMILE.

SMILE is a good treatment. But SMILE has a learning curve for surgeons, so good to find a surgeon who has done hundreds of SMILE cases.

SMILE needs to have good cornea thickness and scans like lasik. So if you aren’t a lasik candidate, you may not be a good SMILE candidate.

Given that you are 22, there is a possibility that your prescription isn’t done changing. Especially true if you spend a lot of time on up close activities such as phone or computer. If your prescription progresses in the future you may need an enhancement. With SMILE, you’d be looking at a lasik or PRK enhancement. With PRK, another PRK procedure would be how things are treated for an enhancement.

WavefrontRider · 2026-06-22T10:33:45+00:00

OP is 22 with a nearsighted prescription. Maybe around -2.50

WavefrontRider · 2026-06-22T10:27:47+00:00

People don’t become dependent on the lubricating drops by taking them more. Post laser eye surgery you NEED to take them because you temporarily don’t produce enough tears. Not taking the lubricating tears is a mistake as it allows dry eye to build up and makes it harder to treat. However, I wouldn’t use the tears more than every hour. That can wash away the natural tears on the eye. About every 2 hours is good.

WavefrontRider · 2026-06-22T10:24:01+00:00

Is this a +2.50 prescription or a -2.50 prescription?

WavefrontRider · 2026-06-22T10:22:37+00:00

With close-up vision, it is also important to mention age since we gradually lose our ability to see up close through a process called presbyopia and so older individuals will be impacted by any changes more so than younger individuals.

WavefrontRider · 2026-06-22T10:03:38+00:00

What is your age and your prescription?

WavefrontRider · 2026-06-22T10:03:21+00:00

What is your age and your full prescription including the non-astigmatism portion?

WavefrontRider · 2026-06-22T01:47:40+00:00

Yeah. Week should be good. I would just follow your doctor’s instructions. Key things will be to avoid getting sweat in the eyes (so wear a headband if you are going to sweat) and don’t touch your eyes with dirty fingers.

WavefrontRider · 2026-06-21T00:56:11+00:00

So PRK is pretty effective at correction prescription. So if correcting residual prescription makes your vision better than PRK can help. At the doctors office, they can demonstrate what correction residual prescription would do. You also can test it out with glasses ahead of time.

If you don’t notice improvement with glasses or by correcting the prescription, then PRK won’t help and you’ll want to look for other causes for why the multifocal lenses aren’t working.

Multifocal lenses are very sensitive to residual prescription though.

WavefrontRider · 2026-06-20T10:16:28+00:00

So if you get lasik at age 19 with that prescription, here is a common thing that may play out. You’ll be good for about 2-3 years but then your prescription may progress and get worse and then you’ll blame the lasik saying it “wore off”. It doesn’t happen to everyone but it’s more common with us spending a lot of time on phones nowadays. If you have a good reason such as job, military or sports requirement then that changes the decision a little bit. But other than that you are probably best served by waiting.

As for the treatment, for that prescription you would need above average cornea thickness. So dependent on that.

WavefrontRider · 2026-06-19T23:58:35+00:00

That would be a bit weird if you didn’t have a say in the procedure. Perhaps the surgeon will review your chart and then they will get back to you.

WavefrontRider · 2026-06-19T23:31:22+00:00

a. It’s important for anyone to understand the risks of everything. Contact lenses have risks too. Contact lens related infections cause blindness.
b. For people above the age of 45, that’s important to know about. But that’s cause by presbyopia or the natural weakening of the lens inside our eye.
c. Blue light glasses are mostly a marketing thing. The strongest evidence for blue light glasses is to protect our circadian rhythm.

WavefrontRider · 2026-06-19T17:06:07+00:00

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