FINDING THE RIGHT LASIK DOCTOR
If you are considering LASIK refractive surgery, make sure you:

• Compare. The levels of risk and benefit vary slightly not only from procedure to procedure, but from device to device depending on the manufacturer, and from surgeon to surgeon depending on their level of experience with a particular procedure. 

• Don't base your decision simply on cost and don't settle for the first eye center, doctor, or procedure you investigate. Remember that the decisions you make about your eyes and refractive surgery will affect you for the rest of your life.

• Be wary of eye centers that advertise, "20/20 vision or your money back" or "package deals." There are never any guarantees in medicine.

• Read. It is important for you to read the patient handbook provided to your doctor by the manufacturer of the device used to perform the refractive procedure. Your doctor should provide you with this handbook and be willing to discuss his/her outcomes (successes as well as complications) compared to the results of studies outlined in the handbook.

Even the best screened patients under the care of most skilled surgeons can experience serious complications.

Most patients are very pleased with the results of their refractive surgery. However, like any other medical procedure, there are risks involved. That's why it is important for you to understand the limitations and possible complications of refractive surgery.

Before undergoing a refractive procedure, you should carefully weigh the risks and benefits based on your own personal value system, and try to avoid being influenced by friends that have had the procedure or doctors encouraging you to do so.

• During surgery. Malfunction of a device or other error, such as cutting a flap of cornea through and through instead of making a hinge during LASIK surgery, may lead to discontinuation of the procedure or irreversible damage to the eye.

• After surgery. Some complications, such as migration of the flap, inflammation or infection, may require another procedure and/or intensive treatment with drops. Even with aggressive therapy, such complications may lead to temporary loss of vision or even irreversible blindness.

Under the care of an experienced doctor, carefully screened candidates with reasonable expectations and a clear understanding of the risks and alternatives are likely to be happy with the results of their refractive procedure.

Advertising
Be cautious about "slick" advertising and/or deals that sound "too good to be true." Remember, they usually are. There is a lot of competition resulting in a great deal of advertising and bidding for your business. Do your homework. 

If you want to know more about advertising ethics, do's and don'ts, or want to report on false advertising, explore the following websites:

• http://www.ftc.gov/bcp/menu-ads.htm
• http://www.ftc.gov/bcp/menu-health.htm

• You may be undertreated or overtreated. Only a certain percent of patients achieve 20/20 vision without glasses or contacts. You may require additional treatment, but additional treatment may not be possible. You may still need glasses or contact lenses after surgery.  If you used reading glasses before surgery, you will still need reading glasses after surgery. 

• Results are generally not as good in patients with very small or very large refractive errors. Patients that require rather weak or very strong glasses or contact lens prescriptions to see well before the procedure are less likely to have 20/20 vision without glasses or contacts after the procedure.

• Results may not be lasting. The level of improved vision you experience after surgery may be temporary, especially if you are farsighted or currently need reading glasses. It is especially important for farsighted individuals to have a cycloplegic refraction (a vision exam with lenses after dilating drops) as part of the screening process. Patients whose manifest refraction (a vision exam with lenses before dilating drops) is very different from their cycloplegic refraction are more likely to have temporary results.

• Some patients lose vision. Some patients lose lines of vision on the vision chart that cannot be corrected with glasses, contact lenses, or surgery as a result of treatment. There is little known about how refractive procedures affect other aspects of vision, such as contrast sensitivity (the ability to see objects clearly against a similar background or in dim lighting conditions). Some studies suggest that patients do not see as well in situations of low contrast, such as at night or in fog, after treatment as compared to before treatment. Therefore, patients with low contrast sensitivity to begin with probably should not have a refractive procedure. It is important for you to know that not all eye centers test contrast sensitivity, and that when it is tested, it should be done in a dark room.

• Some patients may develop severe dry eye syndrome.  As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable.  This condition may be permanent.  Intensive drop therapy and the use of plugs or other procedures may be required.