Ophthalmologists tend to focus on technology adoption and the patient experience as simple ways to boost patient satisfaction, but sometimes the most compelling story is in the numbers. Our practice has found extensive return on investment (ROI) results from clinical decisions made with the needs of my post-LASIK surgery patients in mind.

What began as a clinical observation evolved into a significant growth area in my practice, in terms of both patient outcomes and economic impact. In 2024, only about 15% of my surgical volume came from patients with a history of LASIK, but that small segment represented more than 50% of my premium lens revenue. When you’re looking for meaningful ROI in an ophthalmic practice, those numbers are hard to ignore.

A Career Comes Full Circle

My practice has always aimed to deliver visual independence to patients, centering our mission on using premium lens technologies to achieve the best possible vision without glasses.

As I reviewed my surgery schedule over the past few years, I noticed almost every operating day included at least 2 or 3 patients who had undergone LASIK in the 1990s and 2000s. It makes sense: Those who had refractive surgery 20 to 30 years ago are entering their cataract years. Seeing the data, however, was a moment when the long arc of a career came full circle.

Curious about the scope, I started tracking how many post-LASIK patients I was treating. They accounted for about 10% of my surgical volume in 2023, then climbed to around 15% in 2024 and 16% in 2025. Clearly, this was not a passing trend—it was a wave building momentum.

A Revenue Driver

Of the overall cataract patient population in my practice, about 30% choose a premium IOL such as a toric, extended depth of focus (EDOF), multifocal, or the Light-Adjustable Lens (LAL; RxSight). On the other hand, about 85% of patients who had LASIK in the past elect a premium lens, making them nearly 3 times more likely to choose an upgraded lens option than the average cataract patient.

This differential underscores a key economic point: Not all patient segments contribute equally to practice growth. Identifying and serving the right patient demographic can make an outsized impact on your bottom line while elevating your clinical outcomes and patient satisfaction. For my top tips, see the sidebar, Building a Post-LASIK Practice.

Examining Behavior Patterns

The reasons behind the increased ROI potential in post-LASIK eyes aren’t complicated, but they are multifaceted:

• Post-LASIK patients once made an elective investment in their vision. They’ve experienced life without glasses, and they want that independence back. Additionally, they’re technology-savvy, early adopters, financially capable, and motivated by quality-of-life outcomes.

• Patients with a history of LASIK also tend to present earlier in their cataract journey. While many traditional cataract patients wait until vision decline disrupts their daily activities, post-refractive patients come in at the first signs of visual change. Their expectations are high, creating a natural alignment between patient desires and advanced technology solutions.

• We’re experiencing a demographic bulge and the front edge of a generational shift. The heyday of LASIK was approximately 1999 to 2009. In 2000 alone, 1.4 million procedures were performed, and the average LASIK patient at that time was 31 years old.¹ Fast-forward to now, and these individuals are in their mid-50s, entering the cataract window. The effects from this demographic bulge are not unlike the baby boomers’ effect on cataract surgery. We’re just seeing the front end of this patient wave, and it will grow over the next decade.

As a result of these factors, there is a significant opportunity for practices willing to meet these patients where they are clinically, financially, and psychologically.

The Role of IOL Technology

Like with all cataract patients, IOL selection for those with a history of LASIK plays a crucial role in patient satisfaction. Although some surgeons may routinely implant multifocal IOLs in this population, I find more success with other options, such as an LAL, an EDOF, or a toric lens when appropriate.

About 70% of my post-LASIK patients end up with an LAL. Many come in already asking about it, having done their research online or having heard about it from friends. For others, the choice is easy once we explain how the lens gives us control to refine their vision after surgery. It’s one of the smoothest “yes” conversations we have in the office. The postoperative adjustability restores patient confidence that we can deliver the same crisp, customized vision they enjoyed after LASIK. They can get close with other lenses by targeting plano, but drift is almost inevitable. Additionally, the monofocal design of the IOL eliminates much of the uncertainty inherent in IOL power calculations for post-LASIK eyes. 

Workflow Considerations

From a workflow standpoint, embracing the post-LASIK cataract surgery segment required a few adjustments to patient education and postoperative care. First, we invested in education for our patients and staff, as well as for our referring optometrists. The latter play a key role in identifying candidates early, so we’ve prioritized helping them understand what’s possible for their post-LASIK patients today. Internally, our counselors know that the post-LASIK group requires more upfront discussion about advanced IOL options. We set the stage early with educational resources to help align expectations and improve conversion rates.

Operationally, the LAL necessitated a financial investment and added some nuances to the postoperative workflow, including additional visits and staff coordination for light-adjustment procedures. Such logistics have been discussed previously and are easily managed.^2-5 In my experience, and that of others, the return is well worth the investment,^6,7 and the return on the initial investment can be both rapid and durable.

Most surgeons I’ve spoken with who have integrated the technology echo those sentiments. Patient satisfaction is high, outcomes are excellent, and referrals follow naturally. Additionally, post-LASIK patients tend to be highly vocal ambassadors. They love sharing their experience, telling their family and friends about the LAL. Many new patients come in saying, “My friend just had this done and said I had to see you.” These organic referrals enhance the ROI that keeps compounding long after the initial investment is recovered.

Expanding the Patient Pool: Refractive Lens Exchange

We’re also seeing the leading edge of this trend in refractive lens exchange (RLE). Some of the early post-LASIK generation aren’t yet ready for cataract surgery, but they still express frustration with presbyopia or early lens-change symptoms. Many of them are willing to pay out of pocket for RLE to restore their visual freedom.

A few years ago, that scenario was rare, but today it’s increasingly common. These patients already view vision correction as a worthwhile investment, and they’re motivated to maintain the visual quality they’ve enjoyed for decades. For practices that can offer advanced technology IOLs and excel at patient education, RLE represents another growth frontier driven by the same demographic wave.

The Bigger Picture

What I find most exciting about the post-LASIK segment in lens-based surgery isn’t the economics, but in the alignment of clinical excellence, patient satisfaction, and practice sustainability. These patients appreciate precision and are willing to invest in it. They challenge us to deliver our best work, and, in return, they reward us with loyalty, referrals, and practice growth.

In an era when ophthalmic practices are balancing ever-tightening reimbursement and rising costs, opportunities like this are vital. The post-LASIK patient population represents the kind of win-win scenario that provides better outcomes for patients and measurable ROI for surgeons and their practices.

For me, the takeaway is simple: Pay attention to who’s coming back through your door. Many LASIK patients you treated decades ago are now your most valuable cataract surgery and RLE candidates. Serve them well, and you’ll see the return not just in revenue, but in the satisfaction of helping them see like they did the first time they trusted you with their vision. 

Mark A. Kontos, MD Mark Kontos, MD, is a cataract and refractive surgeon with Empire Eye Physicians in Spokane, Washington, where he brings cutting-edge technology and surgical excellence to the Pacific Northwest. Dr. Kontos is a consultant to RxSight. Reach him at mark.kontos@empireeye.com.

 References

1. Market Scope. Quarterly Updates on the US Refractive Market.Q4-2009 US Refractive Update. Market Scope. Accessed November 12, 2025. http://www.market-scope.com/market_reports/refractive_reports.html

2. Walton OB. Adjusting to the Light-Adjustable Lens. Ophthalmology Management. 2021;25(2):36-41.

3. Schneider R. Finding success with the Light-Adjustable Lens. Ophthalmology Management.https://www.ophthalmologymanagement.com/issues/2024/july/finding-success-with-the-light-adjustable-lens/

4. McDonald MB, De Rojas JO, Mathews PM. Efficiency at every stage. CRST. 2025;24(4):44-49.

5. McCabe CM, Chen KG, Farid M, Thompson V, Jensen MP. Maximizing the potential of light adjustable lenses. CRST. 2024;23(8):38-44.

6. Hunter L. The Light-Adjustable Lens in the real world. Review of Ophthalmology. Accessed November 5, 2025. https://www.reviewofophthalmology.com/article/the-lightadjustable-lens-in-the-real-world

7. Strange T, Josephson J, Soscia W, Richens S, Murphy J, Lee B, Fenzl C, Singleton J, Nelson K, Dean J, Bundrick C, Brenner J, Schwartz D, LaBorwit S. Hear from your peers: a worthy investment. RxSight. Accessed November 5, 2025. https://rxsight.com/rxsight-ed/worthy-investment/