Many of the people with the vision problems described in this section (GASH, multiple images in each eye, and/or loss of contrast sensitivity) are able to find good vision with rigid gas permeable contact lenses (RGPs, aka hard lenses). These lenses succeed in masking corneal imperfections because the light entering the eye is refracted by the contact lens instead of the cornea. Fitting RGPs after refractive surgery can be challenging (due to the changed curvature of the cornea) and requires the expertise of an optometrist specially trained in fitting post-refractive surgery corneas. Not everyone is able to wear these lenses successfully, but those with poor vision after refractive surgery are very motivated and dedicated to finding a long term solution with RGPs, since this is the only way they can see well.
If you, or someone you know is seeking a contact lens solution look for a doctor who is experienced in fitting RGPs on eyes after refractive surgery. VSRN may be able to assist you in finding someone to help.
Enhancements and more surgery
Enhancement is really a euphemism for more surgery. Current technology can surgically correct simple problems, like residual refractive error (defocus) and regular astigmatism (cylinder), although additional surgery for these problems is not always advisable, especially when the residual refractive error is small, due to the risk of overcorrection, as well as creating new, uncorrectable problems, or when there are other problems, such as dry eye or thin corneas.
Current technology cannot reliably fix some problems created by refractive surgery. Optical zones that are too small, off center and/or when the surface is irregular may be made worse with additional surgery. Technology continues to improve, however, and there have been advances in measuring and describing the different visual problems after refractive surgery. However, laser technology has not advanced to the level where the solutions to many problems are reliable enough to recommend considering additional surgery.