Here are questions you should be asking the surgeon BEFORE you make any decision on LASIK treatment.
1. How long have you been performing LASIK?
LASIK is one area of surgery where experience makes a huge difference. Considering the current wide range of experience among Laser Refractive Surgeons in the marketplace, it is important to find someone who has been performing LASIK treatments for at least five years.
2. How many LASIK procedures have you performed in total, and in the past year?
Begin your search for someone who has performed at least 5000 procedures. If looking for strictly LASIK, and not PRK, be specific and have the surgeon exclude surface ablation PRK from his total. It's wise to only consider surgeons who have performed at least 200 LASIK procedures in the past year.
3. What percentage of LASIK candidates do you decline?
Most surgeons will not have a specific number, but you want to know that your surgeon does not think that everyone is a good LASIK candidate. Some patients are better candidates for PRK and some should not have a laser refractive procedure at all.
4. Will I receive Custom WaveFront laser technology?
LASIK treatment can be provided using three different methods - custom, traditional or wave front optimized. Studies show that patients who receive the custom treatments typically have the best chance for great results - with less need for fine-tuning, fewer problems with night glare, and the opportunity to achieve vision superior to the best pair of glasses or contact lenses.
5. What is the likelihood of needing an enhancement (a follow-up procedure) and what is your enhancement policy?
In general, the higher the prescription, the greater the chance of needing enhancement or fine-tuning. Patients whose average prescriptions fall into the low to moderate astigmatism and myopia under -5.00 should expect an enhancement rate under ten percent. This is only a guideline; individual chances could be higher or lower. The surgeon should be able to fully explain their criteria for enhancements and the cost. There should not be a charge for enhancements, nor should there be a premium for life-time enhancements. It is extremely rare for the distance correction of someone to change years after the surgery if they receive treatment with modern Custom WaveFront laser technology. Those that charge a premium for "life-time guarantees" historically have commonly been out of business if something was needed. Unless someone wants Laser Vision Correction before their prescription is stable, this is usually a waste of money. The surgeon's enhancement rate should not be excessively high or low. Enhancements are typically performed at about three months.
6. Who will be performing my preoperative and postoperative care?
The answer should be the surgeon. Unfortunately, too many laser centers bring a doctor in to perform surgery and optometrists or technicians perform preoperative and postoperative care. Minor difficulties can quickly become big problems when not handled properly. All good surgeons should insist on seeing their own postoperative patients. If being co-managed by another doctor for your convenience, make sure that your surgeon will be available to you at all times and for no additional fee. Some surgeons are not available to their surgical patients because they live out of town or work someplace else most of the time.
7. Do I have any evidence of dry eyes and will you write me a prescription for Restasis?
The process of making a LASIK flap causes virtually all patients to have dry eyes for at least the first three to four months. Those who already have marginal tear function or any signs of dryness should have it treated before surgery. Those with a significant dry eye condition may be better candidates for PRK Advanced Surface Ablation or no laser procedure at all. Studies show that individuals who use Restasis, enjoy better visual acuity than those who use only tear drops. Restasis increases your own natural tear production.
8. What is the thickness of my cornea and how much cornea will be left after my LASIK procedure? Will you measure the thickness of my flap during surgery?
The key to safe LASIK is to ensure that there is enough residual cornea left after the flap is made and the laser treatment occurs. There is no absolute consensus as to the amount of cornea to leave untouched. Most surgeons like to leave at least 300 microns at the base after the laser correction. Careful LASIK surgeons measure the thickness of the flap and look at the depth of proposed ablation and check to make sure that there is enough cornea left. The rule of thumb here is: The higher the correction in your glasses, the thicker your cornea needs to be for safety.
9. Will you be using a microkeratome or a laser to make my flap?
Originally, all LASIK flaps were made with a microkeratome (blade). Many of the most experienced LASIK surgeons around the world prefer this method because there is less energy involved in making the flap - allowing for faster healing and less inflammation. Recently, some practices have switched to a laser technique that produces thousands of small explosions next to each other, to create the flap. Those surgeons who have an investment in the laser for flap making feel that their technology is the best, and certainly in the hands of less experienced surgeons, the likelihood of flap complications is reduced . Ultimately, it does not matter whether your surgeon uses a laser or a microkeratome to make your flap as long as they have extensive experience with the technology that they are using. The key is to find the rate of flap complications your surgeon's patients experience. Anything over 1% is very high, but commonly seen with the use of lasers for LASIK flaps.
10. Is there any reason why I am at greater risk for complications than other patients?
This question gives you and your doctor a chance to discuss your general medical history as it may affect your procedure or healing. You should also discuss the desire for pregnancy or recent significant hormonal changes as it affects you and your eyes. You should have a good understanding, after this question, as to the risks, benefits and alternatives to LASIK as they relate to your eyes specifically. You should also have received a thorough discussion of the procedure and postoperative care.
Doctors For Visual Freedom believes that a thorough understanding of LASIK is essential before making an informed decision. They use videos, graphics, check lists of information and a complete LASIK packet to discuss all aspects of LASIK surgery. Dr. Golden will personally go over the risks, benefits and alternatives as they relate to you and your eyes. To schedule your complimentary comprehensive evaluation call 312-291-9680