April 10, 2003 — Will just one LASIK solve your vision problem? New data show some patients are at higher risk of needing a second LASIK.

But there’s good news — even if another LASIK’s needed. Using the same “flap” cut into the eye by the first laser surgery makes second LASIKs safer than ever before.

Peter S. Hersh, MD, and colleagues collected data on some 2,500 eyes from 1,300 LASIK patients.

Overall, a little more than 10% of patients needed a repeat LASIK. The risk was higher for people over 40, who needed a repeat LASIK 14% of the time — significantly higher than the 5% to 9% rate seen in younger patients. The findings appear in the April issue of the journal Ophthalmology.

“This does not suggest older patients do worse or that they have more side effects or complications,” Hersh tells WebMD. “It does show that older patients will have greater chance — compared to younger patients — of needing a second treatment to get the result they want.”

Hersh is professor of ophthalmology at the UMDNJ-New Jersey Medical School in Newark and director of the Cornea and Laser Eye Institute in Teaneck, N.J. He says that patients expect a lot from LASIK surgery — and that doctors should give them a realistic idea of their risk of needing a “touch-up.”

“In general, we can predict the chances of needing a second treatment based on the patient’s age, degree of nearsightedness, degree of astigmatism, and other factors,” Hersh says. “There is a need for each patient to discuss with the surgeon his or her particular situation. It’s important to get an idea of what the particular expected outcome is, and what the chance might be of needing a second treatment.”

Hersh stresses that this is not a safety issue. By using the same cut made in the eye during the first LASIK, second procedures are far less risky. And it’s usually not a price issue. Hersh says that if there’s a need for a second procedure, it comes at “minimal cost to the patients.”

The Hersh study is a big help, says James J. Salz, MD, spokesman for the American Academy of Ophthalmology.

“Most of us didn’t appreciate that older people have a higher reoperation rate,” Salz tells WebMD. “It’s good advice to talk with your surgeon about what to expect. It is not just age, but how high the correction is. Over 90% of the time we get it right with just one surgery. But the patient needs to know there is always a possibility that this will be a two-step procedure.”