As the field of refractive surgery continues to evolve, an increasing number of surgical options are available for LASIK enhancements. Nonetheless, older methods such as AK continue to play an important role in enhancement procedures. Improvements in instruments and techniques allow for previously made LASIK flaps to be safely lifted for additional myopic or hyperopic ablations. Newer methods such as Intacs placement provide an effective option for patients who are not good candidates for further ablative procedures. These advancements allow refractive surgeons to treat a wider range of myopia, hyperopia, and astigmatism effectively in eyes with a history of LASIK surgery.