Are LASIK Lifetime Guarantees a Gimmick?

Are LASIK Lifetime Guarantees a Gimmick?

by Brian Chou, OD, FAAO, FSLS

  • September 18, 2022

If you are contemplating LASIK, you may wonder if a “lifetime guarantee” is worthwhile. It could sway you to choose one laser center over another. The promise of a “lifetime guarantee” is that an enhancement procedure is done at no further cost if several conditions are met. Learn more about these guarantees below.

What is the overall retreatment rate for laser vision correction?

Laser vision correction irreversibly changes the eyes and results can endure forever. However, eyes after laser vision correction will still experience age-related changes with time, as if surgery was not done. There is also variability in the outcome from surgery due to individual healing. Therefore, you can reasonably expect glasses or contact lenses to further improve vision once the eyes have recovered from laser vision correction. However, in most cases, it is not worth getting glasses or contact lenses afterwards due to the drastically reduced need for them. The concept to understand here is that it is unrealistic to expect perfect vision after laser vision correction. The vast majority however experience significantly improved natural vision.

A small number of patients undergoing LASIK or other laser vision procedure, end up undergoing retreatment. For example, a large-scale study with over 41,504 eyes undergoing laser vision correction found the rate of retreatment ranging from 0.48% to 3.14% with differences between 5 high-volume surgeons. Generally, more experienced surgeons have a lower retreatment rate. Established surgeons will point out that their less-experienced counterparts dangle these “lifetime guarantees”.

Most patients undergoing laser vision correction with a good surgeon and advanced technology should not expect to need retreatment.

Requirements of the guarantee

The criteria for the LASIK “lifetime guarantee” can vary from one center to another, at least those that offer it. But it usually requires you to have an eye exam within the center’s network of affiliated eye doctors every year moving forward after the standard post-operative care. While you probably should have an annual eye exam anyways, the criteria to stay “in-network” can limit your choice of providers and pose a problem in you move out of the area. Missing an annual exam in their network could void the “lifetime guarantee”.

Additionally, if you end up in the small percentage that qualifies and should get retreatment, the benefits of additional surgery must outweigh the inherent risks. Some patients do not qualify for additional surgery because of the possibility of making vision worse is too great. In other cases, additional surgery may not be safe and cause irreparable harm. For example, the corneal surface might be too thin to sustain additional tissue removal. Your expectations with retreatment must align with the likely range of outcomes.

Who’s lifetime?

In the early 2000s, several discount laser vision correction centers proliferated such as Lasik Vision Corp, only to fail and go bankrupt. This is a reminder that a “lifetime guarantee” is often not the patient’s lifetime but the laser vision center’s lifetime.

A “lifetime guarantee” appeals to those prone to fear-based scenario planning. But for most undergoing LASIK, the “lifetime guarantee” does not bring compelling value when considering that few patients of accomplished and experienced surgeons need retreatment. Additionally, maintaining eligibility for the “lifetime guarantee” usually means you need to continue annual exams with a limited choice of affiliated eye doctors. Finally, the “lifetime guarantee” is susceptible to cancellation due to business failure of the laser center.

ReVision Optometry is a referral-based practice in San Diego providing contact lens services for patients with keratoconus and other complex eye conditions, including poor results from LASIK and radial keratotomy (RK). Request your examination online or call our office at 619.299.6064.