How to Choose a LASIK Surgeon
But a bad eye procedure outcome can affect your life almost as negatively as a bad heart operation outcome. That's why it is so important to choose the best surgeon available.
Indicators of a quality surgeon can include experience, great credentials and willingness to work with a patient to resolve possible problems following a procedure.
Finding a Good LASIK Surgeon
Factors to consider when you check qualifications and abilities of a refractive surgeon include:
- Licensing. State licensing boards can validate a surgeon's credentials. You also can check a surgeon's credentials through the National Practitioner Data Bank.
- Board certification. Ask if your surgeon is board certified beyond having a basic license to practice medicine. This means that an entity recognized by the American Board of Medical Specialties has certified the surgeon to practice in his or her specialty. The American Board of Ophthalmology is one such entity that requires board-certified physicians to complete specific training and continuing education related to the specialty.
- American College of Surgeons (ACS) membership. The ACS upholds ethical standards of conduct for all members, who must be board certified.
"A lot of companies make LASIK sound like it's a flap-and-zap commodity. But the truth is, it's surgery," said Steve Updegraff, MD, a LASIK surgeon and medical director of Updegraff Vision in Tampa Bay, Fla. He recommends that you choose a doctor who is a Fellow of the ACS. "The credentialing process there is pretty steep; also, that group is diligent about advancing the field of surgery."
Surgeons who use the designation "FACS" after their names are Fellows of the American College of Surgeons.
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- Advertisements. Many refractive surgery centers advertise in newspapers and on radio, television and the Internet. Some ads are more informative than others. Some tout extremely good pricing. But while this can be a starting point, an ad or a procedure price should not be your only criterion when choosing a doctor.
- Referrals. Ask for a referral from your regular eye care practitioner, whether an optometrist or an ophthalmologist. Tell him or her that you want the LASIK surgeon in your area with the best reputation in the profession. Also, reputable LASIK surgeons themselves can be great sources of referrals. If you know of a refractive surgeon who is well respected in another state, call his or her office and ask for recommendations regarding good surgeons in your area.
- Other resources. Visit the American Academy of Ophthalmology's website at www.aao.org, where you can use the "Find an Eye MD" feature. Be sure to specify "refractive surgery" under "specialty." The American Society of Cataract and Refractive Surgery (ASCRS) also maintains an online membership list and "Find a Surgeon" feature.
You might want to start your research by consulting the Yellow Pages and calling refractive surgery centers in your area to find answers to your questions. Also, most refractive surgery centers have websites that explain their specialties and list their doctors' credentials. Some surgical center sites even let you search for specific surgeons, if you have a name in mind.
What To Ask a Refractive Surgeon
After you find a surgeon, make an appointment for a consultation. This is an important meeting. To take full advantage of it, write down as many relevant questions about LASIK and refractive surgery you can think of, and ask every single one during your visit.
Some recommended questions are:
- How many procedures have you done?
- What is your complication rate, and how does this compare with national averages?
- Do you perform procedures at your own center, or do you need to travel elsewhere?
- What are your outcome statistics, and how do these compare with national averages?
- Has the surgical center you use ever had an outbreak of serious eye infections? If so, what caused this?
- If a complication does occur, what is your specific policy regarding follow-up?
- Do you charge extra if an enhancement is required?
- If you do charge extra for enhancements, what kind of a price break can be expected?
- If you don't charge extra for enhancements, what is your cutoff date (one year, for example) for addressing problems after the initial procedure?
- Does your billing department break out and explain all costs associated with a LASIK or other vision correction procedure?
You need to be confident that you have chosen the right person. So if you are not happy with answers to your questions, consult another surgeon.
In addition to the above concerns, you also need to consider the surgeon's versatility and competency in a variety of refractive procedures. LASIK isn't the only game in town, and it isn't the best procedure for every person.
Choose a surgeon who is comfortable and experienced with several procedures such as LASIK, PRK, LASEK, CK and clear lens replacement (refractive lens exchange) and the latest technology. If your doctor displays a thorough understanding of these different procedures, he or she can confidently choose the one that will be best to correct your particular vision problems.
If you're considering a surgeon who doesn't perform a particular procedure you're interested in, ask for an explanation of why, beyond "I don't do that."
It's also a good idea to know if a surgical center has had any unusual or ongoing outbreaks of eye infections, which potentially can be quite serious. With strains of antibiotic-resistant bacteria on the increase, it's essential that surgical center personnel observe impeccable standards regarding sterilizing instruments and equipment.
It's also appropriate to ask if the surgeon performs procedures at his or her own surgical center. Surgeons in this category likely have considerable experience because they perform enough procedures to support a center of their own. If a surgeon needs to travel to an outside surgical center or share a laser, then this may be evidence that he or she performs fewer refractive surgery procedures.
After a consultation, never feel that you are obligated to use that surgeon. You are completely free to talk to other surgeons as well. And don't feel that you are offending anyone. It has long been an accepted practice to seek a second opinion, and most doctors would urge patients with lingering doubts to do so.
The LASIK Surgeon's Office: "That Personal Touch"
While you might hear of a terrific surgeon who practices outside your area, it really is best and far more convenient to find someone close to home. If you do have a rare complication that requires ongoing attention, it will be much easier for you if you can avoid traveling long distances for appointments or even routine follow-up care.
"As with any relationship you have with someone in the medical profession, it has to be one of trust," said Penny Asbell, MD, ophthalmology professor at Mount Sinai School of Medicine and director of Cornea Service and Refractive Surgery Center in New York. "You have to feel that you trust the person and that they're personally interested in you."
She said it's normal to be concerned if you think you lack rapport with your eye surgeon.
"If everything goes well, you probably won't have to see that person too often, and that's the end of it," Dr. Asbell said. "But if for any reason you're not happy with the quality of the result, or there's any issue with healing that's going to require more attention, you want to know that you have someone who is personally connected to you and is working hard to address your concerns someone who isn't just running a mill where they don't even remember who you are."
But to be fair, most good surgeons understandably have only a certain amount of time to spend with their patients when routine procedures are involved. So a good surgeon also recognizes that it's important to have friendly, competent staff available who also can assist with answering your questions and concerns.
The initial impression you receive at the "front desk" may be an important indicator of how comfortable you will be made to feel as you go through the remaining steps of scheduling and undergoing a surgical procedure.
Are staff members friendly or indifferent? Do they seem competent or disorganized? Are they willing to take the time to answer questions, particularly about costs and billing?
Assessing the presence of that "personal touch" may be an important step to take before you commit to any eye surgeon.
[Page updated July 2014]