Monday, October 29, 2012

10 Questions to Ask Your Lasik Surgeon

What are the differences between the many types of LASIK treatment? How can you know if you’re a good candidate for LASIK? And what is the likelihood of success? These are the questions LASIK candidates should ask while researching doctors for Lasik surgery.

The fact is, not everyone is a good candidate for LASIK, and the only way to determine your candidacy is with a comprehensive evaluation. Doctors For Visual Freedom Laser Center offers complimentary LASIK consultations at their convenient John Hancock Center office at 875 North Michigan Ave. in Chicago. Candidates may schedule a complimentary evaluation by calling 312-291-9680 .
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.

Surgeon Dr. Mark Golden is one of the pioneers in the field of LASIK surgery. He has trained hundreds of other surgeons in the techniques of LASIK and has opened more than a dozen laser centers around the United States. He has personally performed more than 23,000 laser procedures, including doctor referrals of patients with severe vision disorders or who have had complications from previous LASIK treatment.

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.

Dr. Golden has performed more than 400 LASIK procedures in the past year, not including any of his PRK or CK patients.

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.

Dr. Golden begins every LASIK consultation by explaining that he only operates on perfect candidates. He wants every patient to be completely happy with their result not just early on, but years after. It is not unusual to find patients that aren’t good candidates, but this analysis should be made by the surgeon, not a source that may be concerned about losing income from the sale of glasses and contact lenses.

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.

Unlike many "discount" laser centers, Doctors for Visual Freedom offers only the latest and best Custom WaveFront technology. Their patients regularly experience the tremendous benefits of Custom WaveFront technology and achieve the best possible results.

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.

At Doctors For Visual Freedom, enhancements are covered for a minimum of one year. In the rare situation where a woman becomes pregnant soon after surgery, the need for an enhancement is much greater than usual. Dr. Golden believes that it is best not to perform any form of Laser Vision Correction while a woman is pregnant or breast feeding. In such a situation, an enhancement would be performed whenever safety dictates. 99+% of our patients eventually achieve 20/20 vision or better. Dr. Golden will always discuss your risk of enhancement as a part of the regular preoperative examination.

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.

Dr. Golden personally performs all preoperative and postoperative care. Their policy is to always have time to answer any and all of your questions at each visit in a relaxed environment. They pride ourselves in caring for patients one at a time (no assembly line service). Their practice is built on referrals because their patients are happy with their care.

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.

Dr. Golden typically prescribes Restasis for all patients who comes in for a laser procedure, but it is only one of many possible treatments. Those who do not have insurance coverage for Restasis should know that there are options, and the doctor will discuss those with patients at the time of their evaluation.

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.

Dr. Golden always measure flap thickness before and after surgery. The amount of cornea that is removed depends on the patient’s prescription, but if the cornea does not have the needed thickness the patient will not be considered a perfect candidate. He feels that it is extremely important that with an elective procedure such as LASIK, surgery should only be performed on perfect candidates and that includes enough corneal thickness.

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.

Dr. Golden prefers to use a microkeratome, although he has performed several thousand LASIK procedures using a femtolaser for flap creation. In an analysis of his patients, when compared with the microkeratome and the laser for flap making, he found that the microkeratome was faster, more comfortable for the patient, and provided faster return of visual acuity.

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.

Dr. Golden will always incorporate the patient’s medical history into his evaluation. He will then take all the time needed to discuss exactly what you should expect from your laser procedure including the risks and benefits for you, your eyes, and your life-style.

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. To take the evaluation to find out if lasik is right for you, answer these questions. If you'd like to sign-up for special offers, register here.
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