Enhancement Policy
Enhancement Policy for Vision Correction
Our Commitment
Our goal for Vision Correction is to provide patients their ideal post-surgical refractive outcome. Sometimes the healing process follows an unpredictable course after cataract surgery. Patients with high pre-surgery refractive errors, previous LASIK or other corneal refractive issues, and patients with a high degree of astigmatism may need additional refractive correction. In these circumstances, the surgeon will review all available pre- and post-cataract surgery information with the patient, and discuss the option of an enhancement procedure to improve the remaining refractive correction. The recommendation is based on the surgeon’s discretion and the patient’s individual needs.
This enhancement policy is valid for one year from the date of the original cataract surgery with Vision Correction at Northwest Eye Surgeons and Whatcom Eye Surgeons of Bellingham. If an enhancement procedure is desired, the earliest wait time between the original surgery and a touch-up surgery, is between 3-6 months. This allows for adequate recovery time from the initial surgery and ensures that the ocular tissues and refractive error/correction are stable. However, there are exceptions, as follows:
Toric IOLs
If the co-managing doctor notes a toric IOL (monofocal toric or multifocal toric) to be misaligned at the required one week dilated postoperative visit, or any time after surgery, promptly inform the surgeon and return the patient to NWES. Toric IOLs can be more easily rotated in the capsular bag within a few weeks of initial surgery than if repositioning is delayed.
IOL Exchange
During the early, post-surgical visits (typically 1-2 weeks), if the vision and refractive error are noticeably off from the planned outcome, IOL exchange may be indicated. Prompt communication and scheduling the patient with a NWES surgeon is crucial. If the surgeon determines–with patient agreement–that an IOL exchange is in the patient’s best interest, surgical and IOL costs are included with the Vision Correction at no extra cost.
Enhancement Procedures and Visits
The most common procedures that we employ during enhancements include IOL exchange, additional laser vision correction treatment, femtosecond laser-assisted astigmatic keratometry (AK) and corneal limbal relaxing incisions (CRI). The choice of specific enhancement procedure will be based on the surgeon’s discretion and the patient’s individual situation.
Clinic appointments following enhancements will be performed at the nearest Northwest Eye Surgeons clinic (or at Whatcom Eye Surgeons in Bellingham if this is the nearest location). Patients enrolled in Vision Correction are not charged for enhancement post-op visits.
We encourage co-managing doctors to consider an inclusive post-surgical fee (3-12 months) that includes potential recheck and enhancement post-op visits. Enhancements and subsequent post-op visits are infrequent, perhaps 15% of patients, and we are happy to provide these services at NWES. In the event that patients prefer to see their co-managing doctor for these added visits, those doctors may want to plan their fee structure accordingly.
Frequently Asked Questions
Are there specific qualifications for enhancements?
Any Vision Correction patient dissatisfied with their visual outcome should be scheduled and re-evaluated at one of the Northwest Eye Surgeons clinics or at Whatcom Eye Surgeons in Bellingham. Decisions to re-treat will be made on a case-by-case basis and in consultation with a NWES surgeon.
Our mutual goal for Vision Correction patients is to obtain comfortable, satisfactory vision. We respect and consider individual circumstances regarding the appropriateness of enhancements. Listed here are general guidelines for enhancements, assuming a patient has healthy eyes.
- For VC1 patients, this refers to 20/30 vision at either near or distance.
- For VC2 patients with a multifocal IOL, 20/30 at both near and distance.
Will enhancement recovery be the same as the original surgery?
Recovery from enhancement refractive procedures may be less traumatic and faster, however, some laser procedures may require multiple post-procedure visits. In the infrequent circumstance of IOL replacement, short term ocular swelling (corneal edema) and inflammation (pseudophakic iritis) may be present for a week or two, but would respond well with topical medicines. Patients will be placed prophylactically on drops similar in regimen to the original cataract surgery.
If you have additional questions, please contact any of our surgical coordinators listed alphabetically here by clinic location, and they will be happy to assist you:
Bellingham (Whatcom Eye Surgeons) – 360-676-6233
Mount Vernon – 360-428-2020
Renton – 425-235-1200
Seattle-Northgate – 206-528-6000
Sequim – 360-683-2010
Smokey Point – 360-658-6224
