LASIK consumers: Follow-up Enhancements?

So my wife is seriously considering LASIK to treat her various eye problems. All of the places she’s considering are including a year of follow-up exams and treatments. A few of the places she’s considering are including in their treatment packages, “Unlimited enhancement treatments at $700 per eye.”

Well, that’s nice.

So, you guys who have been zapped, how often have you needed or wanted an enhancement? Would that extra expenditure be like buying the extra insurance on a new car, or an extended warranty from a fly-by-night business? Or can she reasonably expect to want/need a little tweak maybe 3 years (or ten, or twenty?) down the road?

—G?
Doctor, my eyes!
Cannot see the sky

Is this the price
For having learned
How not to cry?

…–Jackson Browne
Doctor, My Eyes
…Jackson Browne

I had my eyes zapped in 2001, and started needing glasses again for driving and watching TV somewhere around 2009. Apart from driving I can function well enough without my glasses, but almost always prefer to have them on, because why would I want to see just “OK” when I can see well?

I’m supposed to be entitled to lifetime adjustments for $350 per eye, but I’m not sure it would be worth it. At 56 I still don’t need reading glasses, and it’s my understanding presbyopia is not uncommon as a LASIK side effect. I noticed this the first time, when I actually did buy reading glasses, but as I continued to heal I was soon able to dispense with them.

I had mine done less than three years ago, so no changes so far, but the guy who zapped mine said that the probability of needing a top-up is linked to your age. If you’re twenty, then it’s more likely that your eyes will change after the surgery, and you’ll need a top-up somewhere down the line. If you’re thirty-five, it’s more likely that your eyes have stabilised and you won’t need another go-round - although, like Spectre of Pithecanthropus said, you’re likely to need reading glasses earlier than you would have without the surgery: nearsighted people tend to keep their close-range vision longer than people with normal distance vision.

One thing to consider (although you probably already know this) is how thick her corneas are. If they’re relatively thin, then she might not be a candidate for top-up surgery even if she should want it, so there’s no point in paying for the option.

My guy told me that when you’re choosing where to get your surgery done, one huge thing to consider is whether the doctor who assesses you is the same one who’ll be performing the surgery. If it’s not the same person, that can be a problem. The doctor doing the assessments won’t have to actually do the surgery, so he’s more likely to accept a marginal candidate; and the doctor who’s doing the surgery doesn’t see you till you’re all prepped and ready, so she’s under psychological pressure to go ahead even if she thinks you’re not an ideal candidate.

I had mine done six or seven years ago and went from 7/8 diopter to nearly perfect vision. The predictable changes of age mean I needed readers a few years later and a couple of strength increases in them until now, but I still have 20/25+ vision from five feet to infinity.

The bigger change was some recurrence of my astigmatism, which was significant but nearly ironed out by the surgery. It’s recurred to a slight degree and of course can’t be corrected by dime store readers, so I do have a pair of fully corrected glasses - maybe 0.25 diopter and that slight astigmatic correction. They are nice for driving - I don’t strain to see distant road signs - and about 50/50 for plays and movies. (I have invisiline reader panels, too, which helps with reading the dashboard and nav and is good enough for general reading. I use more powerful readers for long sessions.)

I don’t think I’d bother going through another surgery for such minor correction, especially as the close-vision problem can’t be corrected anyway. If I’d had this done at, say, 25, I’d probably look at touch-ups every five years or so for a while.

BTW, I had PRK instead of LASIK - other than a slightly longer healing time, it’s still a superior method. LASIK is the McDonald’s version - in, out, healed(ish) quickly. Take the three or four days and go PRK, especially if the correction is more than 3-4 diopters.

I had mine done in IIRC 2000? Or 1999. My junior year of college, I was 19 or 20. Several years afterwards I started to need glasses to drive at night and to see movie subtitles and such. Now I need them to watch TV. Now, these are MUCH lighter glasses than the ones I needed back then - my vision used to be very, very bad.

So I asked my new eye doctor last year if I should consider enhancing it. And he said that as long as the glasses don’t bother me, and they don’t, he’d recommend against it. The thing is, as you age, you’re going to need reading glasses, probably. An enhancement will mean you’ll need them quicker and stronger.

So he suggests that you make your decisions based on what you like to do - he’s had people who play a lot of golf decide they do want it, because that’s a priority for them. Me, I’m a librarian - I’d rather avoid the reading glasses as long as possible.

The LASIK was absolutely the best thing I’ve ever done, though, I’d say.