The key to safe, successful surgery in any field of medicine is an informed patient with realistic expectations and a skilled, experienced surgeon. Take the time to research not only the procedure but the surgeon and the laser center you are considering for correcting you vision. Ask questions! Don't let cost be your deciding factor. The following guidelines can help you make the right choice to ensure the outcome that you are hoping for.
How to Find A Surgeon
Begin with the people you know. Word-of-mouth provides good initial information. Ask your family, friends and associates if they would recommend a surgeon based on personal experience. An optometrist or ophthalmologist you trust is a good resource. Many eye care specialists have seen the work of several LASIK surgeons in town and have first hand knowledge about who has good results. It is imperative that you feel your refractive surgeon will treat you with your best interest at heart and a high-quality surgeon who has successfully treated friends and family is usually a good bet.
Internet
Physician Search Directories on the Internet may be helpful. These directories may not include all the surgeons in your area who do refractive surgery, just those who have chosen to participate. Listings on these sites are available for a fee and most do not check the surgeon's credentials. That is your job.
Many leading surgeons have taken the extra effort to establish a website that may be linked to these search directories. These websites usually detail their practice along with qualifications and experience. Ask the surgeon you are considering for his or her Internet address.
Advertising
LASIK surgery is one of the fastest growing industries in the world. Last year more than a million procedures were performed and more than 1.6 million are expected this year. Many surgeons and laser centers advertise. Beware of the hard sell and discounters! Be wary of promises or guarantees seen in advertisements like "20/20 or your money back." Many advertisements will push low-cost surgery-a warning signal to proceed with caution. Discount surgery is as good as a discount parachute. Go for a well-qualified surgeon and pay what it costs.
WHAT TO LOOK FOR
Experience with the Procedure
Studies show surgeons experience a learning curve with the LASIK procedure and that the more experience the fewer complications. It can take up to 500 cases for a surgeon to develop his or her nomogram, the formula that the surgeon enters into the excimer laser's computer and determines how the cornea will be reshaped. The nomogram is based on your age, the surgeon's technique, the type of laser and your refraction, which was determined at your preoperative exam.
Even temperature and humidity may influence this formula. The more exact a surgeon's nomogram, the less likely you will need a retreatment. Even in the best of circumstances, however, retreatment may be necessary because different people respond differently to the laser. Does the surgeon feel confident enough with the procedure to have done family members? Find out how much experience your surgeon has with the procedure - the more the better.
Benchmarking
Ask your surgeon how he or she tracks refractive surgery outcomes. If surgeons can quote outcomes specific to their practice they are benchmarking or actively tracking surgical results. They should be able to provide you numbers reflecting their experience with refractive errors (vision problems) similar to yours. They may even be able to have you talk to someone who had a prescription similar to yours prior to surgery. Benchmarking indicates that the surgeon's concern for achieving the best possible results. Your goal is to find someone for whom achieving excellence is of paramount concern.
Success and Complication Rates
The surgeon who benchmarks can quote success and complication rates. Discuss with your surgeon the success rates and complication rates for your individual surgery. Surgical success means not only knowing how to avoid complications but also knowing how to handle difficult situations before they occur. Certain types of eyelid anatomy make the surgery more challenging. Prior ocular pathology may change a surgeon's treatment plan. Beware of the surgeon who claims never to have had a complication. He or she has done very few procedures or is not being truthful. All surgeons have
complications; xperience makes a difference how a surgeon can handle them. What is important is that the surgeon has a low complication rate and the ultimate visual outcomes are good.
Certifications and Awards
Look for a board-certified surgeon. This is the medical profession's generally accepted form of accreditation. This information may be obtained from the American Academy of Ophthalmology. Additional training beyond ophthalmology residency adds some credence to a surgeon's dedication but by itself is not an absolute in determining surgical competency. Many of the finest LASIK surgeons today were performing refractive surgery before fellowship training in the field became available. Participation in research, lecturing and writing professional articles or books also indicate a level of respect by the surgeon's peers. Check to see if your surgeon has been recognized with any awards.
Malpractice Suits
You are able to check to see if a surgeon has be subject to multiple malpractice suits. Even the best doctor may have had a lawsuit against him or her. But multiple lawsuits require an explanation.
Awareness of New Developments
Refractive surgery is a dynamic field. Your doctors should be keeping up with new developments by reading professional journals and attending meetings. Get a sense if your surgeon has information of what is being looked at for the future both nationally and internationally.
Care Provider and Style of Care
Some patients choose to see their family eye care specialist for their preoperative and postoperative care. It is a common practice but be sure you are comfortable with this arrangement. Make sure that your surgeon is accessible to you at any time during your preoperative and postoperative period.
Competent, Compassionate Staff
Most doctors employ a knowledgeable staff to help perform tests and answer questions. Staff should feel comfortable and confident with the entire process of refractive surgery. Have they had the procedure done to them?
Equipment
If your procedure is being performed in the United States, make sure it is done only on an FDA-approved excimer laser. Ask about laser upgrades and maintenance. Remember surgeons in other countries may use lasers that have not had to withstand FDA scrutiny.
Personal Compatibility
Personal chemistry can make a difference in your experience with any type of surgery. You should choose a surgeon with whom you feel comfortable. That person should be easy to talk to, yet professional. Most importantly your surgeon should listen closely to what you want and be willing to take the time necessary for you to understand the procedure. A good doctor-patient relationship is key for the two of you to devise a treatment plan that best suits your needs. Many LASIK surgeons and centers offer educational seminars or one-on-one screening exams. These are excellent opportunities to get to know your surgeon. If you choose to have your own optometrist or ophthalmologist perform your preoperative exam, make sure you are comfortable with their explanation of the procedure. You may feel the need to spend time talking with your surgeon before the procedure. Make sure this is available to you.
Take Your Time
You have probably worn glasses or contacts for most of your life. There is no rush to decide who will do your refractive procedure. Take your time and ask whatever questions you need to feel comfortable with your choice. Laser refractive surgery has improved the eyesight of more than a million people in the United States and nearly the same number throughout the world. Most refractive surgery patients report that having laser surgery is the best decision they have ever made. Your refractive surgeon need not be your best friend but you should have the confidence that that he or she has the skills and experience to perform the procedure.
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