What do I need to consider about secondary LASIK surgeries in my later years?

In most cases, LASIK is a one-off procedure that lasts many years or decades. No secondary LASIK is required in such cases.

Occasionally, some pre-existing spectacle power may reoccur, and this is called regression. If significant regression occurs, an 'enhancement' procedure can be considered whereby the LASIK flap is lifted, and then laser treatment is applied to remove the residual spectacle power.

The main question regarding suitability for 'enhancements' has to do with how thick the cornea is after the first LASIK. If the cornea is already at the limit of the acceptable remaining thickness (what some people call 'too thin'), then your doctor will advise against any further laser treatment. In this case, glasses or sometimes contact lenses remain options to achieve clear vision.

If you are above 40 years of age at the time and myopic regression is present (ie there is some remaining shortsightedness/myopia), some people may elect to leave things as they are, because the little bit of myopia helps them to read.

These are some of the important considerations-mainly for the issue of regression. There may be other scenarios, and the best thing to do if you have any specific concerns would be to consult a doctor who performs refractive surgery for further discussions.

I assume that your question is referring to an enhancement procedure (either for regression of power or the onset of presbyopia) depends on the safety of performing such a procedure.

1. Ensuring that no other ocular pathology exists (including senile cataract), that would benefit from a different procedure
2. Sufficient corneal tissue is present (for further enhancement)
3. Appropriate target refraction is chosen for an appropriate reading distance (most important if monovision is desired to be spectacle free for both distance and near reading)
4. Whether an adjuvant procedure including collagen cross-linking is indicated.