I had monovision lasik 3 months ago. I had an enhancement for an undercorrection in my dominant eye on 8/19. My enhanced vision is the same as it was before the enhancement or perhaps even a little worse! My 24 hr. post op doc said the eye is healing well and not to be concerned about the vision. When will the improved vision come? Does an enhancement always work? It has now been 4 days since the surgery. What is a reasonable amount of time in which to see improvement. Thanks.

I also had an enhancement on one eye 10 months after my original lasik. I was not immediately happy with the enhancement because of over corection and astigmatism. My dr. determined that epithelium cells were growing beneath the flap of the enhanced eye, and while these cells were at the edge of the flap not in my field of vision, they could be changing the curve of my cornea enough to cause the less-than-perfect vision. My options were to lift the flap and wash out the cells (a third surgery on that eye) or wait and watch to see if the cells were absorbed. I decided to have the the third surgery and I am glad that did! Within a few days my vision in that eye was 20/20 or better and has remained so for 2 months now.

If there are no epithelium cells causing a problem, how long does it take to see an improvement after an enhancement? I sense no difference in my distance vision yet. What is reasonable? Does an enhancement always produce better vision? I have another post-op visit in 5 days.

Five days may be too soon to judge how you will eventually do. Give it more time and ask your surgeon for feedback.
Leonard Friedman MD

Thank you for your feedback. It has been one week today, and I do not think my vision is any better than it was prior to the enhancement. In fact, it may be a little bit worse as far as distance is concerned. I am willing to be patient. I see my dr. again on Monday. I will ask him his opinion. Is it possible that the enhancement did not "work"?

It really is too soon to come to any conclusion about your enhancement surgery. Lifting the LASIK flap for an enhancement can be additionally disruptive and make healing the second time around a bit slower than the first time. Any swelling (corneal edema) will cause you to have a little more myopic (nearsighted, shortsighted) vision and uneven swelling can cause astigmatism or distorted vision.

To give you some perspective, a full diopter of correction requires the removal of about 12 microns of corneal tissue. One cell of the outermost layer of corneal cells is about 5 microns wide. That means that even one cell being out of whack can cause enough vision disturbance to be notice. Well, not one individual cell, but you get the idea.

Give your eyes at least 1-3 months to heal before you come to any conclusions.

Glenn Hagele
http://www.USAEyes.org

I am not a doctor.