Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 10/31/18 11:04 AM
The answer to this varies depending on who you ask. If you ask a low-cost LASIK provider, the answer will almost certainly be “yes.” If you choose quality over cost when deciding on your LASIK provider, the answer is usually that there isn’t a charge. If you were to ask Socrates, the answer would be a question. The truth about the additional cost for a LASIK enhancement is that it’s never free, the different answers will be based instead on whether you or your LASIK provider will pay for it.
First off, why isn’t it free?
Don’t you just use a laser to fine tune the treatment? Well, yes. Yes you do just perform additional laser. But here’s the surprising fact about lasers. They cost money to use. I don’t just mean in a “electricity isn't free, and it costs money to pay staff” kind of way. I mean it there is an actual fee to be paid each time the laser is used. They call it a “click fee,” I assume in an attempt to make it sound cutesy instead of grifty. The laser is bought and owned by the doctor or clinic, and then each treatment can only be done by buying the cards or codes for each individual use. It’s like buying a Camry and then paying Toyota a fee when you want to use your car.
For LASIK practices, there are practical reasons to choose “for” or “against” on whether to wrap up the cost of an enhancement procedure into the original cost of LASIK. The likelihood of needing an enhancement has a fair amount of influence in the decision. The percentage chance that you’ll need an enhancement varies widely from clinic to clinic. And you can imagine that if a practice has 30% of their patients returning for enhancements at some point, they’ll say, “Holy smokes! We better charge for this or we’re going to be doing free laser every fourth time we use it! Wait, is that math right? Three people get LASIK and pay, and then one comes back for laser again, so yeah he's the fourth and... it is right! Holy smokes!”
Quality vs. Cost
Here’s where it gets interesting. The same features that define a LASIK practice that chooses quality over low cost are the features that decrease the chances of needing to have an enhancement. More expensive lasers, better instrumentation and diagnostics, high-quality medical technicians, availability and ease of aftercare, follow up visits as often as needed... it's a long list. When everything is done right, enhancements can become an exceptionally unlikely procedure. When corners are cut wherever possible, enhancements become much more common.
The correlation between the cost of LASIK and the cost of a possible enhancement correlates strongly for this reason. Namely, LASIK that costs more because a premium is placed on quality over bargaining is much more likely to have zero or a nominal fee for enhancement. In general, a practice that places enough priority on doing everything the best way possible will want to make sure that you get the best result possible—even in the unlikely scenario that it involves a second procedure. The premium placed on excellent results enables high-quality LASIK practices to do that when enhancements are as rare as they can be and should be.