Lasik vision correction:  Questions to Ask When Shopping For a LASIK Surgeon

When shopping for LASIK eye surgery and  a LASIK surgeon, the cost should not be your first question. Why not? Well, surprisingly low quotes will almost certainly turn out to be higher, and if they don't you can assume that cheap or outdated equipment was used, and/or shortcuts taken during your laser eye surgery. A reliable and competent eye surgeon must invest in expensive equipment in order to deliver the best results for you. Besides that, you have one pair of eyes to last for life; don't you want to give them the best laser vision procedure there is?
Here are the most important questions to ask your prospective LASIK surgeons, and yes, you should interview several before deciding on one, to find as much eye surgery information as possible.

Will you be doing the entire vision correction process yourself?

You don't want to be shuffled off to an assistant, or someone in training. It's best to have your chosen doctor be the one who examines you to begin with, decides on the treatment plan, does the LASIK procedure, and follows up with you afterwards. That way you know you'll be in consistently good hands.

How many LASIK procedures have you performed?

The answer to listen for is a number over 500, and preferably over 1,000. LASIK surgeons use computers to guide the laser beam, but who programs the computer? You want someone with plenty of experience at creating treatment plans, carrying them out, witnessing the results, and dealing with any problems that might have arise during your laser vision correction treatment. If you know the name of the particular type of LASIK procedure you'll be having, ask how patients has the surgeon has performed that specific laser surgery upon.

Where did you receive your training?

There are many tertiary institutions which train doctors in how to do LASIK as a correction procedure. You could contact the relevant institution to ask about the surgeon's academic career and performance.

Can you give me some references?

Most established LASIK surgeons can put you in touch with some of their previous patients, who will tell you about their experience and results.

What professional associations do you belong to?

A doctor who has several professional memberships is more likely to be keeping up to date and in touch with his or her peers. It's best to have a LASIK surgeon who is enthusiastic enough about his work to pay for those memberships, to go to professional events, possibly take advanced or specialized training, and maybe even write journal articles or books about LASIK vision correction surgery. The American College of Surgeons has stiff credentialing and is diligent about promoting surgeries. There are also the American Academy of Ophthalmology, American Board of Ophthalmology, and the American Society of Cataract and Refractive Surgeons, as well as various university and state organizations.

If I have questions as we go, will you have time to answer them?

All doctors are busy people, but an organized and responsible doctor will have time to spend with you, to answer questions, calm fears, explain procedures, and clarify details. If you choose a LASIK surgeon who inspires your confidence, you can be calmer about the whole procedure, and will most likely follow his instructions at each step of the way, which will be to your benefit.

What is the name of the equipment you use?

You may not recognize the names, but write them down and do a little research afterwards. Get the full names, not just the company name, because there are often improved models developed and you wouldn't want a surgeon who is still using old equipment when precision is the name of the game in eye surgery. Some good names to hear will be VISX Star 4, LADARVision, Wavefront-Guided LASIK, CustomVue LASIK, and Bausch & Lomb's Zyoptix. These are not complete names, nor is it a complete list, so get the details and do some online searches to confirm the reputation of each piece of equipment.

What sort of follow-up will there be?

There should be a minimum of four follow-up visits so the surgeon can check on your vision improvement. Ask if this same surgeon will do your follow-up too. Ask whether there might be follow-up procedures possible if you are not happy with the initial results.

How often is the microkeratome incisor changed?

The microkeratome is a surgical instrument which cuts the little corneal flap so that the laser can work on the next layer down, the stroma. The incisor should be fresh for every patient. There are some "LASIK factories", which process large numbers of patients as quickly as they can, and keep costs down in many ways, so as to make a bigger profit. Re-using the incisor is sometimes a way of keeping costs down.

What financing plans do you offer?

Although we warned you away from cost questions at the beginning of this article, of course you need to ask about it. Just don't make cost your decisive factor in choosing the surgeon. Most LASIK surgeons offer several ways of financing the procedure, so choose one with a plan that fits your budget and time frame. Remember that in the long run, you'll be glad you paid for quality work.

10 Things You Need To Know About LASIK Vision Correction

1. LASIK isn't for everyone

Before undergoing any LASIK procedure, you should have a thorough eye exam. Any good LASIK surgeon will do this to determine whether you're a good candidate, although some facilities which emphasize profits over quality will do it perfunctorily or even not at all.

Good outcomes are important to a good LASIK surgeon. So it's in his/her interests as well as yours to test your vision and overall eye conditions carefully before going ahead with any LASIK procedure. If your cornea is too thin, your pupil diameter too large, or the cause of your vision problem is not any refractory error, then you need a solution other than LASIK.

As well, if you're:

· Pregnant
· Under 18
· Diabetic
· Have any of a variety of diseases
· Are taking certain medications
you will not be a good candidate for LASIK.

2. LASIK treats only certain eye conditions

If your vision problem is caused by irregularities in the shape of your corneas:
· Nearsightedness
· Farsightedness
· Astigmatism
you may be a good candidate for LASIK. If your vision problem has any other cause, then other procedures will be needed to correct it.

3. LASIK doesn't treat presbyopia

Presbyopia is often mixed up with hyperopia, farsightedness. As we age and start needing reading glasses, we can often still see well in far distances, so it might seem that if LASIK can correct farsightedness, why can't it correct presbyopia too?

It can't, because presbyopia is caused not by the shape of the corneas, but by two other things:

· The lens becoming more stiff with age
· The tiny eye muscles becoming more weak

So from the combination of those two trends, we have a decreasing ability to focus at different distances. At first we can still see at far distances and just need correction for near distances. But eventually far distances become more of a problem too.

4. The laser used is a cool one

LASIK uses an excimer laser, which is a cool beam of very tightly focused ultraviolet light. There's no possibility of heat hurting your eyes. All lasers give off heat, but the excimer laser penetrates to only a microscopic depth of the cornea and its action is to vaporize tiny pieces of corneal tissue such that your vision will be corrected. As it does that, its heat is dissipated also. This process is called photoablation.

All lasers are man-made, and for specific different purposes. Excimer lasers are made from a mix of reactive and inert gases, which when electrically stimulated, produce a kind of molecule called a dimer. The name excimer is a combination of excited and dimer.

5. Excimer lasers are incomprehensibly precise

The excimer laser beam used for vision correction is 0.25 microns wide. That's about 0.5% of the width of a typical human hair. This microscopic diameter makes it extraordinarily precise.

We know that tools are only as good as the person using them, and with the excimer laser system, a technician specifically trained in these systems, is in charge, working with your eye surgeon. This technician sets up the laser system, which incorporates a computer, microscope, patient bed, and other controls for the surgeon's use. Then he operates it in cooperation with the surgeon.

6. Wavefront-guided LASIK is even more accurate than traditional LASIK

Wavefront technology is a recent addition to LASIK procedures. It's also called Custom LASIK, because by so accurately diagnosing the problem, it customizes the vision correction you receive.

Wavefront diagnostic can, and many feel should, be done on all LASIK candidates. It can be done separately from using Wavefront-guided LASIK to treat the problem. It works by sending special light into the eyes, which reflects back to the Wavefront system, carrying with it detailed information about the irregularities on your corneas.

This information is expressed as a 3-D map of your corneas on the computer monitor, and translated into mathematical formulae that your eye surgeon uses to guide the laser in correcting your problem.

7. LASIK is a quick and painless procedure

Before the procedure is begun, anesthetizing eyedrops are applied. Many of us don't like to have someone else touching our eyes, and some are alarmed at the idea of a laser shining into their eyes. Some eye surgeons also offer medication such as Valium if you feel very anxious.

The laser itself is used for only seconds. Exactly how long would depend on how much correction was needed but it would be less than about 20 seconds. The entire procedure takes about 20 minutes for both eyes. Afterwards you may feel a slightly scratchy sensation, but most people don't need any pain medication.

8. There are restrictions on your activity in the recovery period

For the first week or so, you need to wear an eye shield when you sleep. This is to prevent pressure being put on your eyes. For the same reason, don't touch or rub your eyes.

· You can shower or bathe, but no swimming
· No eye makeup for a week or so
· Normal activity starting the day after surgery, but no contact sports for a few weeks

9. Follow-up is required after a LASIK treatment

A good eye surgeon will give you a series of follow-up visits, starting the day after your procedure, and then approximately:
· A week later
· A month later
· 3 months later
· 6 months later
· 1 year later
These visits are to check on the healing, both short-term and long-term, and on the vision improvement and patient satisfaction.

10. There's no guarantee of 20/20 vision

Many people do achieve 20/20 vision after a LASIK surgery. But a good eye surgeon does not guarantee it. There can be complications sometimes. LASIK will correct only certain eye problems, so if you have any other problem that affects your vision, it remains after LASIK surgery.

As we all grow older and need reading glasses or contact lenses at some point. There are some ways to treat presbyopia or refractive error and the future will probably bring us more, but LASIK doesn't treat it.

Do check with your doctor to consider all available options when it come to eye care. Learn what your option maybe and risk associated with your choice. Your eye LASIK surgery may not be able to provide and end to refractive errors and focusing power, but should ease the dry eyes problem often associated with the use of a contact lens. Refractive surgery may effect vision loss.

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