Short answer: Yes, you can have cataract surgery or refractive lens exchange (RLE) after LASIK or PRK, and many people who’ve had laser go on to have a premium lens, such as an extended depth of focus (EDOF) or multifocal lens, to reduce their need for glasses. The only real difference is the planning. Because the laser reshaped your cornea, standard lens calculations are less accurate in your eye (Savini & Hoffer, 2018). Newer-generation lens formulas and corneal measurements, designed for eyes that have had laser, have made the choice of lens power more accurate (Pan et al., 2024; Lawless et al., 2020).

Many people who had laser eye surgery in their 20s or 30s are now in their 50s and 60s, needing reading glasses or developing a cataract. This guide explains why the planning is different, what newer formulas have changed, whether a premium lens suits you, and what it costs.

Can I have lens surgery after LASIK or PRK?

Yes. LASIK and PRK reshape the cornea, the clear window at the front of your eye. Cataract surgery and refractive lens exchange work on the lens inside the eye, behind the iris: the natural lens is removed and replaced with an artificial intraocular lens (IOL). The two don’t interfere with each other, and the operation itself is the same as in an eye that hasn’t had laser.

Why the lens calculation is harder after laser

Before lens surgery, your surgeon measures your eye and uses a formula to choose the lens power that will give you the focus you want. After laser eye surgery, three things make the standard approach less accurate (Savini & Hoffer, 2018; EyeWiki):

  1. The cornea’s power is misread. Standard measurements estimate the power of the whole cornea from its front surface. Laser changes the front surface but not the back, so that estimate no longer holds.
  2. The wrong part of the cornea is measured. Standard keratometry measures a ring outside the central zone that the laser flattened or steepened.
  3. The lens position is misjudged. Many formulas use corneal curvature to predict where the new lens will sit inside the eye. A cornea reshaped by laser throws that prediction off.

What that means for you: after LASIK or PRK for short-sightedness, standard calculations tend to choose a lens that is too weak, leaving the eye long-sighted after surgery. After laser for long-sightedness, the error tends to go the other way (Savini & Hoffer, 2018). This is well known, and it is why eyes that have had laser are planned differently.

Always tell your surgeon if you’ve had laser eye surgery, even many years ago, and even if you’ve forgotten which type.

How newer formulas have made the choice more accurate

Lens calculations after laser have improved in steps.

Older methods relied on your records from before the laser: your prescription and corneal measurements back then, used to work out how much the laser changed your cornea (the “clinical history” method) (EyeWiki). Those records are often missing or incomplete, and a 2018 review reported that, even with the methods then available, about 60–70% of eyes treated for short-sightedness ended up within 0.50 D of the planned focus (Savini & Hoffer, 2018).

Formulas designed for eyes after laser followed, such as Barrett True-K, Haigis-L and Shammas, along with the American Society of Cataract and Refractive Surgeons (ASCRS) online calculator, which combines several methods (Wang, Hill & Koch, 2010). Many of these work without your old records. In a 2020 meta-analysis of 16 studies of eyes after laser for short-sightedness, the ASCRS average and the Barrett True-K “no-history” formula gave the most accurate results (Li et al., 2020). A 2024 network meta-analysis of 24 studies (1,172 eyes, 12 formulas) also found Barrett True-K no-history among the most accurate methods, ahead of Haigis-L (Pan et al., 2024).

Measuring the back of the cornea. Modern instruments can measure the back as well as the front surface of the cornea, so the cornea’s total power no longer has to be estimated. In an Australian study of 72 eyes that had had laser, combining this “total keratometry” with the Barrett True-K formula gave the smallest average error, in eyes treated for both short- and long-sightedness (Lawless et al., 2020).

The newest generation of formulas includes PEARL-DGS, Hoffer QST and EVO 2.0. In a 2024 study of 139 eyes after laser for short-sightedness, the typical (median) error was 0.39 D with PEARL-DGS, 0.53 D with Hoffer QST and 0.65 D with Barrett True-K, compared with 0.85 D with Shammas and 1.11 D with Haigis-L (Oh et al., 2024). A study of 576 eyes reported in 2024 found that newer formulas outperformed older ones, and that versions using measurements of the back of the cornea did best (AAO summary of Anter et al., 2024).

What this doesn’t mean. No formula is perfect in these eyes, and the studies don’t agree on a single best one: when the formulas in the 2024 PEARL-DGS study were fine-tuned to that clinic’s results, the differences between them were no longer significant (Oh et al., 2024). That is why surgeons often compare several modern formulas for each eye. A small remaining prescription after surgery is still possible, which is why fine-tuning matters (see below).

Bring your old records if you have them

If you still have your records from before the laser, such as your prescription and corneal measurements, bring them, or ask the clinic that treated you for a copy. History-based methods use them (EyeWiki). Don’t worry if you can’t find them: several of the most accurate modern methods don’t need them (Li et al., 2020; Pan et al., 2024).

Can I have a premium EDOF or multifocal lens after LASIK?

Often, yes. Premium lenses reduce your need for glasses at more than one distance (see lens types explained):

  • Extended depth of focus (EDOF) lenses give good distance and intermediate vision (computer, dashboard), with some near vision.
  • Multifocal (trifocal) lenses focus at distance, intermediate and near, giving the most freedom from glasses for reading, with more halos at night.

What the evidence shows in eyes that have had laser:

  • Overall. A 2022 meta-analysis of 13 studies (445 eyes) of presbyopia-correcting lenses after corneal laser found that 82% of eyes saw 20/25 or better at distance without glasses. Most people didn’t need glasses for near or intermediate tasks. Halos (40%) and glare (31%) were the common side effects (Sun et al., 2022).
  • Trifocal. In a 2024 study of the PanOptix trifocal lens, 73% of eyes that had had LASIK and 75% of eyes that hadn’t were within 0.50 D of the planned focus, a difference that was not significant (Cao et al., 2024).
  • EDOF. After LASIK for short-sightedness, an EDOF lens gave distance vision similar to a standard monofocal lens, with better intermediate and near vision (Ferreira et al., 2018). In a 2025 study of the Vivity EDOF lens, 70% of eyes after LASIK and 87% of eyes without LASIK were within 0.50 D of the planned focus, a difference that was not significant in this small study (Fan et al., 2025).
  • Higher original prescriptions. In a study of multifocal lenses after laser, eyes that had more than −6 D of short-sightedness before the laser had less predictable results (Vrijman et al., 2017).

Who suits a premium lens after laser? Your surgeon will check:

  • The shape of your cornea, with corneal topography. A well-centred, regular laser treatment suits premium lenses best. An off-centre or irregular treatment can blur the image, and a simpler lens may give better quality of vision.
  • The surface of your eye. Dry eye can affect both the measurements and how clear your vision is with a premium lens, so it is treated first. See dry eye and halos after LASIK.
  • How you use your eyes, including night driving. If halos would bother you, an EDOF lens, accepting glasses for fine print, may suit you better than a trifocal.

Lenses we use include the TECNIS PureSee EDOF lens and the Rayner RayOne Galaxy spiral lens, as well as multifocal and toric lenses (see lenses we use). Your surgeon will recommend one after examining your eyes.

What if the result isn’t spot-on?

Even with careful planning, a small prescription can remain after lens surgery. It can usually be fine-tuned, most often with laser once your eye has settled. In a study of 186 eyes that had had corneal laser before a trifocal lens, laser fine-tuning afterwards was safe and effective (Mayordomo-Cerdá et al., 2022). Your surgeon will check that your cornea is suitable for further treatment.

After refractive lens exchange at Focus Vision, laser fine-tuning is free for two years under our enhancement policy, when it is stable, safe and worthwhile.

Some clinics use the Light Adjustable Lens, whose power is adjusted with UV light after surgery. Focus Vision doesn’t currently offer it; see our view of the Light Adjustable Lens.

How we plan your surgery

  1. Tell us about your laser at booking: what you had, roughly when, and where. Bring any old records.
  2. Detailed measurements, including corneal topography and optical biometry, to assess the shape and power of your cornea and the length of your eye.
  3. Your surgeon compares modern formulas designed for eyes that have had laser and chooses the lens power for your target focus.
  4. We talk through the lens options (monofocal, EDOF, multifocal, toric) and what’s realistic for your eyes.
  5. After surgery, follow-up visits check your result, with fine-tuning if it’s needed.

Our surgeons audit their lens surgery outcomes against published benchmarks using the Refractive Outcomes Analyzer, a free tool they built for cataract and lens surgeons.

Cost: cataract surgery or refractive lens exchange?

Medicare and health fundsPrice per eye at Focus Vision
Cataract surgeryMedicare-eligible; health funds with Cataracts hospital cover pay towards it$2,500 to $5,500, depending on your health insurance and lens choice
Refractive lens exchangeNot covered by Medicare or health fundsfrom $6,000, all-inclusive, including the premium lens and anaesthetist

Prices are from our costs page; prescribed medications and eye drops are extra. Having had laser doesn’t change whether you’re covered: what matters is whether you have a cataract. See refractive lens exchange cost and cataract surgery cost for details.

If you’ve had LASIK or PRK and are thinking about lens surgery, book a free optometrist assessment or call (07) 3239 5005. Bring your old laser records if you have them.

References

  1. Savini G, Hoffer KJ. Intraocular lens power calculation in eyes with previous corneal refractive surgery. Eye Vis (Lond). 2018;5:18. doi:10.1186/s40662-018-0110-5. pmc.ncbi.nlm.nih.gov/articles/PMC6053834
  2. American Academy of Ophthalmology. Intraocular lens power calculation after corneal refractive surgery. EyeWiki. eyewiki.aao.org/Intraocular_lens_power_calculation_after_corneal_refractive_surgery
  3. Wang L, Hill WE, Koch DD. Evaluation of intraocular lens power prediction methods using the American Society of Cataract and Refractive Surgeons Post-Keratorefractive Intraocular Lens Power Calculator. J Cataract Refract Surg. 2010;36(9):1466-1473. pubmed.ncbi.nlm.nih.gov/20692556
  4. Li H, Nan L, Li J, et al. Accuracy of intraocular lens power calculation formulae after laser refractive surgery in myopic eyes: a meta-analysis. Eye Vis (Lond). 2020. doi:10.1186/s40662-020-00188-1. pubmed.ncbi.nlm.nih.gov/32656291
  5. Pan X, Wang Y, Li Z, et al. Intraocular lens power calculation in eyes after myopic laser refractive surgery and radial keratotomy: Bayesian network meta-analysis. Am J Ophthalmol. 2024;262:48-61. pubmed.ncbi.nlm.nih.gov/37865389
  6. Lawless M, Jiang JY, Hodge C, et al. Total keratometry in intraocular lens power calculations in eyes with previous laser refractive surgery. Clin Exp Ophthalmol. 2020;48(6):749-756. pubmed.ncbi.nlm.nih.gov/32279436
  7. Oh et al. Accuracy of the PEARL-DGS formula for intraocular lens power calculation in post-myopic laser refractive corneal surgery eyes. Am J Ophthalmol. 2024;259:79-87. pubmed.ncbi.nlm.nih.gov/37914063
  8. American Academy of Ophthalmology. Editors’ Choice summary of Anter et al., comparison of legacy and new no-history IOL power calculation formulas in post-myopic laser vision correction eyes (Am J Ophthalmol. 2024;264:44-52). aao.org/education/editors-choice/posterior-keratometry-values-may-improve-m-lvc-iol
  9. Sun Y, Hong Y, Rong X, et al. Presbyopia-correcting intraocular lenses implantation in eyes after corneal refractive laser surgery: a meta-analysis and systematic review. Front Med (Lausanne). 2022;9:834805. pubmed.ncbi.nlm.nih.gov/35479941
  10. Cao et al. Comparing clinical outcomes of trifocal intraocular lens in patients with and without prior history of laser in situ keratomileusis for myopia. BMC Ophthalmol. 2024;24:406. pubmed.ncbi.nlm.nih.gov/39289687
  11. Ferreira TB, Pinheiro J, Zabala L, et al. Comparative analysis of clinical outcomes of a monofocal and an extended-range-of-vision intraocular lens in eyes with previous myopic laser in situ keratomileusis. J Cataract Refract Surg. 2018;44(2):149-155. pubmed.ncbi.nlm.nih.gov/29526338
  12. Fan W, Zhu M, Zhang G. Visual outcomes and spectacle independence of a non-diffractive wavefront-shaping intraocular lens in post-LASIK patients. Front Med (Lausanne). 2025;12:1509889. pubmed.ncbi.nlm.nih.gov/40470056
  13. Vrijman V, et al. Multifocal intraocular lens implantation after previous corneal refractive laser surgery for myopia. J Cataract Refract Surg. 2017;43(7):909-914. pubmed.ncbi.nlm.nih.gov/28823437
  14. Mayordomo-Cerdá F, Ortega-Usobiaga J, Bilbao-Calabuig R, et al. Laser corneal enhancement after trifocal intraocular lens implantation in eyes that previously had photoablative corneal refractive surgery. J Cataract Refract Surg. 2022. pubmed.ncbi.nlm.nih.gov/34670947
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Brendan Cronin

MBBS (Hons), DipOphthSci, B.Com, LLB, FRANZCO, FWCRS

Dr Brendan Cronin is a corneal, cataract and refractive surgeon and co-founder of Focus Vision in Brisbane. He is the Director of Education at the Queensland Eye Institute, completed his corneal fellowship at the Manchester Royal Eye Hospital in the UK, and teaches corneal and refractive surgery techniques to ophthalmologists internationally. He co-created the CAIRSPlan surgical planner and the free Focus Vision Refractive Outcomes Analyzer.

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