LASIK: Choosing a Surgeon

Refractive surgery in general and LASIK in particular have received a lot of attention over the past several years, with more and more people electing to seek out more permanent ways to reduce their dependence on eyeglasses or contact lenses

Two of the most difficult variables for potential LASIK candidates to evaluate when they are searching for the best place to have their surgery done are the cost of the procedure and the skill of the surgeon who will perform this intricate procedure. Many refractive surgery centers have sprung up and many of them use various media to advertise their presence and expertise, but how is a potential LASIK patient to know if one center is better than the next, based merely on the size of the advertising budget available?

While costs of the surgery are, of course, important to many people, cost alone should not be the only consideration in this important decision. You should consider your refractive surgery and its costs as an investment in yourself, which is not something that should come with the lowest price tag. It is much more important to assure yourself that you will get the benefit of an experienced, skilled practitioner who will be focusing on you and your eyes.

Step One: Rely on your own Eyecare Practitioner

Your eyecare practitioner is an invaluable source of information and can usually recommend at least two or three reputable local surgeons. Eyecare practitioners often perform pre-surgical examinations and do at least some of the necessary follow-up evaluations, and therefore see the results of many surgeries and will have a good feel for the consistency and accuracy of individual surgeons. Your own eye doctor can help steer you in the right direction.

Contrary to the hype generated by the media, LASIK (or any other refractive procedure) does not actually mean that you will never have to wear glasses again, or that you will never have to see your eye doctor again. For one thing, changing the shape of the front surface of your eye does not make the inside of the eye different; if you were nearsighted before the procedure, your eye will still be nearsighted on the inside, and therefore susceptible to ocular health issues that should be evaluated regularly. For another, no reputable surgeon will guarantee that your surgery will have a specific outcome; in fact, such claims would be a good reason to look elsewhere for your operation.

Step Two: Ask Questions

When you have narrowed down your choices to one or two, make an appointment for a consultation, which is usually at no cost or low cost. This is an important meeting, because it will give you a chance to ask any and all questions you may have and to clear up any concerns prior to your surgery. It is also beneficial for the surgeon, because he or she can better determine if you are a good candidate and can give you a better idea about what to expect.

Some questions that are important to ask include:

• How long has the surgeon been performing refractive procedures, and how many of them has he or she done? As with any other type of expert service, experience matters. There is a "learning curve" associated with any medical procedure that is exponential; learning is very rapid in the beginning and levels off rather quickly after the procedure is done several times. In practical terms, this means that you probably don’t want to be one of the first few patients a surgeon practices his techniques on, as a newer surgeon will have a higher rate of complications than more experienced doctors.
• What percentage of patients achieve uncorrected vision of 20/40 or better? Eyesight in this range is judged to be adequate for driving without corrective eyewear. Usually, only very experienced surgeons will have a rate of 90% or more.
• Are there a few previous patients who would be willing to talk about their procedures and results? Patient privacy is an important consideration, but good and experienced surgeons can usually furnish at least some patient testimonials. You should be cautious if the surgeon categorically refuses to provide any information about previous cases.
• Has the surgeon ever had his or her license to perform refractive surgery or practice medicine revoked, suspended or restricted? This question can cause some discomfort in both doctor and patient, but is important to evaluate the surgeon’s skill and ability to perform the procedure, but their general practice policies and professional reputation. Reputable surgeons will be forthcoming with this information.

Candidates considering refractive surgery should be wary of laser surgery centers that advertise sale prices or package deals that are only good for a limited time; this is only a ploy to rush you into a decision.

What to Expect as a Refractive Surgery Patient

Once you have decided who will perform your surgical procedure and where, and have had a chance to ask any questions you might have, an appointment can be scheduled.

LASIK is an outpatient procedure, meaning that you walk into the surgery center before your appointment and walk out again later the same day. Most surgical centers have a policy that patients must have transportation arranged as many patients will be given a mild sedative to help them relax prior to the procedure. (Many laser centers offer family members or friends to watch the procedure on video if they want to do so.)

The surgery itself takes about one minute per eye and patients are awake the entire time. The eyes will be completely numbed with eye drops which will prevent any sensation or pain.

The surgeon has complete control over the laser and can turn it off at any time. Usually, both eyes are done on the same day, often in succession, unless patient and surgeon have earlier decided to postpone the second eye surgery to another day. Most LASIK patients experience improved vision within minutes and feel nothing more than mild discomfort afterwards. Patients are given antibiotic drops to prevent infection and shields to place over their eyes for the first few nights to prevent accidentally rubbing them and dislocating the position of the flap, which will heal over within a day or two.

Patients should follow the surgeon’s instructions carefully and ask questions if necessary.

Follow-up care is very important for LASIK patients; while complications and adverse events are very rare, they do occur, but most of these are very easily treated if caught early. Keep all appointments for your own peace of mind and return to your eyecare practitioner or surgeon immediately if you think there may be a problem.

Most people are able to return to work and other normal activities within a day or two, although swimming and hot tubs should be avoided for at least one month, because the water could introduce micro-organisms into the eyes and cause an infection.

Questions are always welcome and you should feel free to contact your eyecare practitioner if you have any concerns.