Cost is probably a big factor (maybe the biggest factor) in your deciding who does your laser correction procedure. As a rule, we have found that the most perfectionist laser providers tend to have the higher fees. By the same token, we also find that the least perfectionist laser providers tend to have the lower fees. Regrettably, many low-cost providers do not appear to be concerned with the most elementary things that will influence your outcome. Here are some of the basic things that are most often overlooked...
- Operating room humidity. This influences the miosture of the surface to be lasered - too much or too little room humidity causes differences in the tissue thicknesses of your eye, making the laser remove too much or too little tissue, thus producing over- or under-correction.
- The timing and speed of each part of the procedure. Taking too long or moving too quickly again affects how dry eye tissues become, again leading to over- or under-correction.
- How often the laser is calibrated. The longer the time between calibrations, the more "slop" in the system, leading to more erratic, less predictable results. Also, how often the laser lenses are replaced (they wear out and degrade) will cause the same thing. Proper servicing costs a great deal of money, and many laser providers, in order to contain costs, may not do the right thing.
- Replacement of the flap-cutting blade. Re-used blades can influence the result on subsequent eyes, leading to inferior results. The best and most predictable flaps are now made with a flap-cutting laser instead of a blade at all!
- Feedback from those doing the follow-up care. The best providers absolutely insist on timely follow-up documentation from their associate doctors. This information is fed back into the system to constantly upgrade the precision level of surgical outcomes. Associate doctors who fail to report this follow-up information are summarily discharged as associates. Unfortunately, when many laser providers conclude their procedures, they show little interest in follow-up information. They simply move on to the next patient.
Interestingly, you will likely find that, no matter who does your surgery, the difference in your vision afterward compared to before will be dramatic. Therefore, you may readily conclude that your outcome was a great success. We have seen several patients with generally poor results who were ecstatic with their vision. It's only after the initial novelty wears off that they wonder whether it could have been better. Paying somewhat more up-front is a reasonable way to eliminate that uncertainty.
When it comes to a permanently life-changing procedure like laser surgery, choosing a perfectionist is the way to live with no regrets. We think this deserves careful thought because your vision is meant to be one of life's greatest enjoyments.