Special to the Recorder
In last week’s column, I wrote about the origin of Lasik eye surgery and how the surgery is performed. As mentioned, Lasik eye surgery side effects and complications are possible and though uncommon, need to be addressed successfully.
First, let’s remember: Lasik is just one of 14 Laser Vision Surgeries among more than 40 Vision Corrective Surgeries (surgeries to remove glasses and contact lenses). Your surgeon must be qualified and experienced to perform all of these or else you are getting a “cookie-cutter” procedure.
With a worldwide referral of Lasik complication cases over nearly three decades, I will in this column summarize four reasons for poor outcomes in Lasik surgery, and then review guidelines to consider when choosing a Lasik surgeon:
Misleading advertising by a Lasik practice
• Some Lasik practices have surgeons who may be new and inexperienced themselves but use the established name recognition of their more experienced, senior partners (who may have actually even retired from the practice).
• Lasik eye surgery “mills” advertise the joint number of cases done by all chain centers across the nation (e.g. 500,000 cases done) while their surgeon may be a novice.
• Some Lasik practices use celebrity testimonials (e.g. NFL players, movie stars, etc.). In many such cases, the practice actually pays a hefty sum to be known as official surgeons of such celebrities or professional sports teams and/or they most often will do surgery for free to get an endorsement.
Lack of patient education and expectations
• Patients are not educated about other available vision corrective surgical options since the surgeon may themselves not be capable of performing the full spectrum of surgical options.
• Patients feel intimidated to ask questions about surgeon qualifications, vision expectations, side effects, etc.
Cookie-cutter surgery by a Lasik practice; “One size fits all”
• Lasik may be all that the Lasik practice performs. They may be ignorant or incapable of performing the entire range of Laser Vision Surgeries. (Remember: Lasik is just one among these Laser techniques.)
• There may be a lack of knowledge, initiative or expertise in offering and performing alternate vision surgery options if Lasik is not ideal for the patient (e.g. new generation ICL surgery for thin cornea patients who are not ideal Lasik candidates).
Poor pre-operative technological analysis of the patient’s eye anatomy, vision and stability.
• There may be a lack of understanding on the surgeon’s part regarding interaction between anatomy, physiology and optics of the eye to get a great vision outcome.
• There may be a lack of technological finesse to detect early abnormalities and avoid Lasik in improper candidates.
• There may be an inability to deliver the best outcomes due to lack of modern, cutting-edge technology.
Guidelines to keep in mind when choosing a Lasik surgeon
• Besides visiting the surgeon’s website, use a search engine (e.g. Google, MSN, Yahoo, etc.) and type in the doctor’s name and see what comes up. Do you find only a website and other paid advertising claims? Or do you find interviews, published articles and third-party confirmations of the doctor’s status?
• If your surgeon says that they are the first or that they teach other Lasik surgeons, ask for evidence. Are they first in the world, country or state (decreasing order of importance), or just on their street, zip code or town?
• Meet with the surgeon, get a feel for the integrity and involvement of the surgeon in educating you and answering every question. Also make sure that your surgeon is contactable and that they do indeed respond when you call.
• Make sure that your surgeon will see you before surgery, perform your surgery and also see you and be available after your surgery.
• Find out if your surgeon performs the full spectrum of Laser Vision Surgery (remember Lasik is just one of many Laser Vision techniques) so they can offer what is truly best for you, rather than suggesting the only surgery they know how to perform.
• Do not fall for flashy computer screens and equipment in the office; make sure that you understand all that is going on and insist on asking the surgeon to explain in layman’s terms.
• When meeting your surgeon, ask about possible side effects and complications. Ask if in the rare event that you do end up having a complication, can they handle it? If the answer is yes, then ask for evidence.
Thus, due diligence on part of the patient, experienced selection of individualized surgery by the surgeon and effective use of modern technology can all together raise
the bar on safety and predictability in LASIK — one of the most successful surgical breakthroughs of modern times.
Each year, patients from around the world travel to Jacksonville’s Gulani Vision Institute to have their vision corrected by ophthalmologist Arun Gulani, MD. A Ponte Vedra Beach resident, Dr. Gulani has been a leader in LASIK, cataract and astigmatism surgery, has invented Lasik complication corrective techniques and is often called upon to train other surgeons in the latest groundbreaking technologies.
