By Cobra
LASIK: free consultation - $499 per eye.” Teaser ads such as this one promote the erroneous view that laser eye surgery is so simple that buyers should shop for the lowest price.
The introduction during the past year of wavefront technology, often called “custom” lasik, has spurred even higher expectations for perfect vision. Developed by astronomers to correct atmospheric distortions, in light waves, wavefront technology has been adapted to map the human eye, and then to customize laser soft-ware before vision-correction surgery.
Studies show that such wavefrontguided Lasik can reduce the chances of post-surgical complaints such as night-vision problems, halos and related side effects. But wavefront doesn’t change the risks of conventional Lasik, which is short for “laser-assisted in situ keratomileusis.” The procedure still requires a surgical incision to create a flap on the cornea that can become infected, causing permanent damage in the eye. The flap is folded back to ex-pose underlying tissue that is re-shaped by the laser pulses.
Better Results Are Reported
Data submitted by laser makers to the Food and Drug Administration prior to wavefront marketing approvals show that patients “had significantly better results in vision quantity and quality,” says Glenn Hagele, founder and executive director of the Council for Refractive Surgery Quality Assurance, a nonprofit organization in Sacramento, Calif. However, “even with the best doctor and the best technology you can have undesirable results. There are no guarantees,” he cautions.
People who are considering laser surgery should be aware of the potential problems. Web sites, including surgicaleyes.com and lasikdisaster.com, offer up horror stories.,Mr. Hagele’s organization operates two sites, usaeyes.org and complicatedeyes.org, which are re-sources for people seeking a surgeon or treatment for a post-surgical problem.
There are a lot of controversy surrounding estimates of Lasik complication rates, which generally cluster around 3%. Such estimates, however, rarely include patients who have undergone “enhancement,” a second procedure to improve initial results. Some refractive surgeons say that wavefront is reducing the number of unhappy customers by tailoring surgery to the individual eye and by helping identify poor Lasik candidates before they are treated.
Procedure Isn’t for Everyone
Wavefront typically adds $100 to $400 to the cost of conventional Lasik, which runs from $500 to $2,500 per eye. There also are differences among the wavefront and laser systems sold by Alcon Inc., Visx Inc. and Bausch & Lomb Inc. Some systems may be better for some patients, depending on their eyes.
One reason that the best Lasik surgeons tend to have happy patients and a low complication rate is that they decline to treat people who are poor Lasik candidates. People with very dry eyes, thin corneas and large pupils are problematic, for instance. And the surgery may be a bad idea for nearsighted people over 40 who simply remove their distance glasses in order to read close up.
“Lasik is a miraculous procedure, but it has been overly simplified and overly sold. It is in fact a very complex medical procedure;” says Andrew Caster, an eye surgeon in