LASIK Success Depends on the Surgeon

By Eric R. Mandel, MD

Published on July 20, 2006

At this year's International Society of Refractive Surgery (ISRS) Conference, I lectured to LASIK surgeons on cutting edge technology and developing sophisticated computer nomograms to improve their results. (A nomogram is the surgeon's personalized calibration of a patient's prescription, which is unique to that surgeon and the laser he uses. This is directly proportional to the surgeon's experience and his/her ability to control environmental factors such as temperature and humidity in the procedure room.) Despite having these great new tools at our disposal, I cautioned the LASIK surgeons that LASIK is becoming more, not less, surgeon dependant. Therefore, patients need to be even more vigilant in choosing their LASIK surgeon.

In the beginning, many patients assumed that with the evolution of refractive surgery and improving technology, a good outcome with LASIK surgery would become less dependent on the surgeon, yet the opposite is true. Advanced technology has created new possibilities. Using and understanding these new technologies requires a more skilled and experienced surgeon. Having said that, patients need to understand that LASIK is not a new procedure. For 95% of patients, there is no need to wait for further developments in refractive surgery. Our technology is already multigenerational and well established. In fact, LASIK is not a new procedure. It is a combination of two earlier procedures. The flap part of LASIK is called keratomileusis. This has been around for over 50 years. The laser that is used in LASIK has been in use on human corneas for 16 years. LASIK is a combination of these two well-established procedures. But remember, it is still the surgeon that makes it all happen.

The following are suggested questions to consider when choosing a surgeon:

Q: How many procedures has the doctor performed?

A: Should be 5,000 or more.

Q: Will your surgeon perform the postoperative exams personally?

A: Yes, they should. If not, go elsewhere. During the postoperative exams, subtle adjustments to your eye drop regimen can optimize your results and these decisions should be made by your surgeon.

Q: Will the surgeon spend time with you in consultation at your preoperative evaluation?

A: Yes. If not, go elsewhere. You need to develop a trusting relationship with your doctor. This may take time but it is to the patient's advantage. In addition, all of your questions and concerns should be addressed personally by the surgeon prior to your procedure.

Q: If you are over 40, did your surgeon explain your customized choices for reading vision?

A: If not, they are using the "one size fits all" approach and all patients have different lifestyles and needs postoperatively.

The bottom line in choosing your surgeon is that you must feel comfortable with his/her credentials and bedside manner. This is why it is critical to meet your surgeon prior to your procedure and have him/her follow you for all of your postoperative visits.

Eric R. Mandel, M.D., is founder and medical director of New York LASIK Vision Correction.

For more information on the author, please visit www.mandelvision.com

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