Monday, December 27, 2010

The LASIK Lifetime Guarantee

How valuable is a LASIK "lifetime guarantee"? Well not as valuable as you might think. Why? There tends to be a lot of strings.
What’s the catch?
1. The lifetime guarantee only applies to patients within certain parameters. They typically are not available for farsightedness, or for patients with more significant amounts of nearsightedness or astigmatism.
2. The lifetime guarantee only applies if you get an excellent outcome on your initial LASIK procedure. The guarantee is void if you need an enhancement or “touch-up” procedure.
3. The guarantee only applies if your vision changes to significantly more nearsightedness (worse than 20/40). What if you drift to 20/30 or become farsighted as you age? Sorry, you’re on your own.
4. The guarantee allows only for additional LASIK procedures. Of course, there is a limit to the number of times a LASIK procedure can be performed and the guarantee does not apply to procedures such as conductive keratoplasty which may be a better option for you as you age.
5. The center determines the advisability of further LASIK. This does not allow for the participation of the patient in the decision making.
6. The “lifetime” referred to may be the lifetime of the center. We have seen several patients who were patients of now defunct laser centers who found that their lifetime guarantees were worthless. And what happens if LASIK itself becomes defunct? Witness the history of the old RK procedure.
7. You may be required to undergo yearly exams at an affiliated doctor’s office. Miss one of these mandated exams and your guarantee becomes void. Such restrictions are an unnecessary burden and expense making it difficult and in some cases, impossible for a patient to meet their obligation under this arrangement.
Much more important than any type of guarantee is the reputation and trust you have in your surgeon. Be sure and ask "what happens if my eyes or vision needs change?" and make sure you are satisfied with the answer.

Saturday, December 25, 2010


One of the most common questions potential LASIK patients ask is that of cost. Patients are often befuddled by the wide variability in prices charged for a LASIK procedure. Consumers often make the mistake when inquiring about price that they are comparing apples to apples. But over the years the LASIK procedure has evolved and changed so that there are many different techniques and technologies available to correct vision with variable success and safety profiles. In addition there are variable amounts of service associated with the fees charged.

As a general rule, the lower the fee, the less surgeon-patient interaction there is. The reason is that lower fees mean that more patients need to be treated in order to generate the same level of income as fewer patients at a higher fee.

There are other factors that can account for differences in fees even if you meet the surgeon at every visit before and after surgery. The more experience of the surgeon, typically the higher the fee. In other words, the greater the expertise, the higher the fee. As with any profession, some surgeons are more skilled than others which includes not only surgical expertise, but also diagnostic expertise as well since LASIK is not always the best procedure for everyone. Some patients may be better suited for other procedures and some patients should not have surgery at all.

The equipment and physical plant is another cost factor. There are several studies that confirm that an environmentally controlled room is essential to good LASIK outcomes. The surgical suite should have a separate heating and cooling unit from the rest of the clinic. Humidity must be strictly controlled. An air filtration system may have some impact on outcomes. There are several different manufacturers of flap making devices and lasers to perform the procedure all with varied prices and associated costs just as there are different makes and models of automobiles. Which would you want: a Ferrari or a Hyundai? In general, an all-laser or blade-free LASIK procedure is safer and more precise than a standard LASIK but costs more. A wave-front guided procedure costs more than a wavefront-optimized procedure which costs more than a conventional LASIK. The more expensive techniques tend to give better results and fewer side-effects such as night-time driving difficulties.

There will always remain those patients who seek only the lowest price but the educated LASIK consumer should seek to investigate further before settling on their vision correction provider.