home lasik
laser
tour
Choosing a Laser Surgeon LASIK at Quality Eye Care Testimonials
 

HOW DO I CHOOSE A LASER SURGEON?

There is no easy answer to this question. Eye surgeons and laser facilities are not subject to universal standards and are not all equal. Would you have a heart bypass operation without meeting your surgeon? Would you shop around for a heart surgeon on the basis of price alone? Obviously, the answers to these questions are no. If what patients are telling us is true, that their eyesight is one of their most precious possessions, why should the answers be any different for eye surgery? The following are suggestions, but remember, you only have one set of eyes, so pick wisely.


Recommendations
Certification
Experience
How much is the surgeon doing?
Laser facility
Importance of meeting the surgeon before choosing
Price
Complication rate

Recommendations
While asking friends who have had LASIK might be a start, friends are not always experts in these matters; the truth be told, they may have come by their surgeon by chance, perhaps leafing through news ads. Their surgeon may be very good, but do your own homework and substantiate their recommendation. Ask your family physician or internist whom he or she would recommend. If you are already under the care of an ophthalmologist, ask whom he or she would go to for LASIK. If your ophthalmologist performs LASIK, use the additional criteria below. If your ophthalmologist is experienced in LASIK and has earned your trust, you may already have the right person.

back to top
 
Certification
You want a board-certified ophthalmologist. Though such certification is no guarantee of a quality LASIK surgeon, it is a reasonable standard to expect of a doctor. A surgeon who has additional "fellowship" training in corneal surgery is sometimes touted by laser centers. Most ophthalmologists have performed corneal surgery during their training. Fellowship-training is no guarantee of a more skilled LASIK surgeon. While it is true that LASIK surgery is performed on the cornea, one must not lose sight of the rest of the eye. Fellowship-trained corneal surgeons who only specialize in the cornea may not have continuous clinical exposure to other parts of the eye. While there exist no widely-accepted uniform standards for LASIK training, hospital-affiliated laser facilities may hold ophthalmologists, in general, to more strict standards than non-hospital centers where there is less federal and state oversight.

back to top
 
Experience
Your LASIK surgeon should be experienced and have good results. How can you get this info? Ask the doctor at the screening exam. Ask to speak with some of the surgeon's patients to get a sense of their satisfaction. How much experience is enough? The learning curve of LASIK depends on the surgeon; some are fast-learners, and others, slow learners. While you might not want a surgeon who has only done a few cases, going to a surgeon who has done "thousands" is no guarantee of a better or even average result. Such a high-volume surgeon may not be able to give you the one-on-one care you should seek. Your surgeon should have done at least one hundred cases. Beware of being seduced by advertisements claiming "thousands of refractive surgery procedures performed". Oftentimes, these "thousands" include older surgical procedures such as RK or radial keratotomy, which is an entirely different type of surgery, or these "thousands" include all the cases of several surgeons using an open-access laser facility. Besides, dwelling on the numbers beyond a certain point misses the whole point: you should care about the quality, not the quantity.

back to top
 
How much is the surgeon doing?
Your surgeon should not only do the surgery, but be involved with the screening exam, the pre-operative exam, and the post- operative care. The surgeon is ultimately the one best-trained to determine whether a person is a good candidate for LASIK, not the counselor. The surgeon should be the one examining and measuring the patient at the preoperative exam. The measurement of the prescription is critical, as these numbers are the basis of the numbers that are programmed into the computer of the laser. Certainly, there are things that can be delegated to others in the name of efficiency, but not this. The surgeon doing the surgery is also best-suited to examine you after surgery. Your surgeon should feel responsible and accountable enough to see you after surgery. At some chain discount laser centers, the only time you may see your surgeon is at the time of surgery!

back to top
 
Laser facility
What laser facility does the surgeon use? Remember, the laser is a very delicate instrument that must be well-maintained by trained and experienced technicians. The humidity, temperature, and even ventilation of the laser room must be controlled and kept constant; otherwise, LASIK become unpredictable. For these reasons, be wary of mobile laser systems; these are lasers that are trucked from office to office on pot-holed expressways. There are justifiable concerns about possible malfunctioning equipment, not to mention the non-transportability of the critical operating conditions of temperature, humidity, and proper ventilation.

back to top
 
Importance of meeting the surgeon before choosing
It is critical for you to meet with the surgeon well before surgery, at the initial consultation. How can a surgeon know his or her patient just on paper? Nothing can substitute for the one-on-one meeting. It's important for the patient to be comfortable with the surgeon. Good rapport or bedside-manner is important. If you can't communicate with your doctor at the time of the screening, why would that change during surgery or afterward? Your doctor should answer questions in a friendly, unhurried fashion that won't make you feel like you're on an assembly-line. There are many LASIK surgeons. You should take your time choosing one. Given a choice between a competent surgeon who doesn't have the time to meet with you, and another who does, why wouldn't you want to choose the one willing to make a commitment?

back to top
 
Price
Price can be an important factor for patients. Prices for LASIK go from cheap to very expensive. Paying the most is no guarantee of a better result or even an average one. On the other hand, consumers should be wary of high-volume facilities with big advertising budgets that advertise prices that sound too good to be true. Oftentimes, there are add-on charges on top of the advertised, low introductory price.  Additional charges may apply for patients who have stronger prescriptions or astigmatism.  Some facilities charge extra for retreatments and even postoperative care. The notion that postoperative care is an "extra" or option is ludicrous and unethical, and at best, misleading. Postoperative care should always be included in the surgical package. High-volume facilities sometimes hire surgeons fresh out of training and are oftentimes paid on a per-eye basis, which rewards fast surgery and volume. Ask how long the surgeon has been at the facility; turnover is frequent. This is assembly-line medicine. There are always issues of compromising quality, safety, and service for the sake of profit with large corporate entities. It is ironic that the profit-motive may be more of a problem on the low end of the pricing tier, where margins are very low. These are the places where you may not meet your surgeon at the screening, where your surgeon may not do your preoperative exam, and where the person who examines you after surgery is not the surgeon. While comparison shopping on the basis of price alone makes sense when it comes to buying a car or household appliance, eye surgery is clearly not a commodity, and should not be treated as such.

back to top

 
Complication rate
All surgeons have complications, even the best LASIK surgeons. The true test of an excellent LASIK surgeon is how he or she handles a complication, and how the patient does in the end. While a LASIK surgeon who performs many surgeries will have more complications than someone who does fewer cases, the percentage of complications should be at least the same (and probably lower). Ask your LASIK surgeon about his or her complications. A competent surgeon should not be offended by such a question nor should that surgeon boast about a "zero" complication rate. If a surgeon tells you that there are no complications, be very suspicious. He or she is either being dishonest or not doing enough cases. Ask your surgeon if you can talk to a patient who has had a significant complication, but ultimately had a good result. You may not be seriously interested in doing so, but you can gauge your surgeon's reaction to your request.

back to top


 

 



© 2005 Quality Eye Care, P.C. All rights reserved. LEGAL NOTICES