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Wednesday, September 19, 2007 

LASIK Thought of the Day: Enhancements

Enhancements are another name for "touch-ups" after a LASIK procedure. If the vision is not full corrected by the initial procedure, an enhancement is usually recommended. Enhancements are rarely done sooner than three months after the initial procedure. In our practice, most enhancements are performed between the third and twelfth post operative month. During the first year, it is uaually easy to "lift" the LASIK flap, and add a few spots of laser treatment to the bed. After the first year, it becomes more difficult to lift the flap, especially when the flap was created with the IntraLase. IntraLase flaps adhere more tightly to the underlying cornea than microkeratome flaps. While many LASIK surgeons maintain they can lift a flap many years after the initial procedure, we would note that complicationns, such as tearing the flap, or epithelial ingrowth are more likely as time goes by. For this reason, we are big fans of PRK enhancments 18 months, or more, after the initial procedure. In our experience, flap lift enhancements work well for the first 18 months. After that, PRK enhancements offer greater safety and effectiveness. We are not enthusiastic about creating a second flap under any circumstances. The old flap edges may join up with the new, and create an undesirable "splintering" effect.

Mitchell Friedlaender, M.D.
Scripps Clinic Laser Vision Center
La Jolla, CA

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  • I'm LASIKblog
  • From La Jolla, California, United States
  • Mitchell Friedlaender, M.D., is Head of the Division of Ophthalmology, and Director of the Laser Vision Center at Scripps Clinic, in La Jolla, CA, and Adjunct Professor at The Scripps Research Institute. He is a cum laude graduate of the University of Michigan Medical School, and received his ophthalmology training at Harvard University, and the University of California, San Francisco. He was a full time faculty member at the University of California, San Francisco before joining Scripps Clinic in 1986. He is the author of 6 books and over 250 scientific articles. He has lectured at universities throughout the world on conditions such as blepharitis, allergy, dry eye, and infection. He is the recipient of the Senior Honor Award of the American Academy of Ophthalmology, and a member of the American Ophthalmological Society, an honor society composed of 300 leaders in ophthalmology. He has been listed every year, since 1986, in The Best Doctors in America.
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