<p>My DD, age 24, would like to have LASIK surgery. She got some recommendations from friends and coworkers. In looking at the websites, it looks like there are a variety of medical professionals who perform the surgery. MD, DO, OD. My gut feeling is to go with the MD, and one with lots of experience with the procedure.</p>
<p>Anybody have any experience with this? Any recommendations on how to choose the correct person to operate on the only pair of eyes that one has?</p>
<p>I haven’t had it done, but I would go to an ophthalmologist at a major teaching hospital or, if you have in one your area, a specialty eye hospital.</p>
<p>I had my eyes done at a clinic in Montreal because the modern procedure had been approved there for years and they had over 10000 surgeries done. But - and this is my point - they were recommended by a doctor here. I would ask an eye professional. </p>
<p>The procedure is nearly all computer done.</p>
<p>Opthamologist, but I would avoid any teaching hospitals. Asking how many surgeries they have done is a good idea.</p>
<p>An OD does NOT perform Lasik but often co-manages a Lasik case.</p>
<p>My husband is an Ophthalmologist, and my son is having the procedure tomorrow (not by my husband). You want an Ophthalmologist who performs the procedure on a regular basis. Be sure to ask who will do the follow up, and who you would see if you had a problem post-op. You want it to be an Ophthalmologist (MD), not an Optometrist (OD).</p>
<p>Why avoid a teaching hospital?</p>
<p>I agree with Pizzagirl and earlier poster. Do not avoid teaching hospitals! Go with the surgeon who has the best training, expertise and results. That may very well be a surgeon associated with a major teaching hospital or academic medical center.</p>
<p>Thanks everyone. Another question: Is it common to charge for the consultation, and then apply that toward the cost of the procedure if you proceed with them?</p>
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<p>Umm, because the students would be learning on you. They’d be under supervision, of course, but still…I don’t think so!</p>
<p>Some of the most experienced surgeons (and best trained) work at academic medical centers and teaching hospitals. They have access to the latest techniques and may actually have done research on techniques. Also, LASIK and many other types of refractive surgery are performed in a surgeon’s office, not in a hospital where residents do procedures. So, unless you have evidence suggesting that results of surgeries performed by physicians associated with teaching hospitals are not as good as those performed by doctors at nonteaching facilities, you’re simply perpetuating a fallacy by suggesting that people avoid these places.</p>
<p>Remember you only have one set of eyes. And at 24, the eyesight will keep changing with age so getting rid of glasses is relatively short term. And any problems encountered are going to be with you in a very unhappy way for an extra long time.
You want someone who does this every day–on a regular basis with many successful operations behind them. That is one reason to not go to a teaching hospital–the most trained and regularly practiced professionals doing this are not in the hospitals. they are busy making their living at it. Don’t be a guinea pig of any type. Do some google searches to find out the questions to ask in finding a good surgeon for LASIK surgery–not just a surgeon. Don’t just rely on your neighbor.
Lots of MDs have certification to do LASIK since its a great money maker but you want someone who has done a 1000 or so.</p>
<p>All I know is that if I were having this done, I would call Wills Eye Hospital (I live right outside of Philadelphia) for a recommendation. I would trust them to refer me to someone on their staff who has indeed done many, many of these procedures. (And then of course I would get other recommendations as well.) The two things - experience with the procedure and teaching hospital affiliation - are not mutually exclusive.</p>
<p>What booklady said. There are doctors at academic medical centers who are fellowship trained in refractive surgery. The notion that these doctors are not experienced (as a result of being at a teaching hospital) is utterly uninformed. You should go to the best surgeon you can find who has experience, training and good results in a particular procedure. Not considering surgeons at a major academic medical center in your area could mean not considering the best-trained and most skilled surgeon available.</p>
<p>Do not go to one of the mills that advertise on TV. They may have done 1000 of them but perhaps not with good results. (In addition to asking the doctor how many, also ask for complication rates, what kinds of complications, etc.)</p>
<p>I had mine done by an MD who came highly recommended by a childhood friend who is one of the leading researchers who developed LASIK. Even with that recommendation, I waited until several freinds and family members had this doctor do their LASIK and when they had no problems and were very happy, I then had mine done. And it was the best thing I ever did!</p>
<p>Booklady and absweetmarie are absolutely correct. You want the best and brightest - affiliation with a teaching hospital / major medical center is absolutely a strong indicator of that. Doctors at a teaching hospital have to stay sharp because they’re training students, doing grand rounds, etc. Docs at a community hospital without teaching responsibilities may or may not be improving / refining their skills, and it’s a lot easier for them to do slipshod work and not be “caught.”</p>
<p>The operation is almost completely computer done. When I had it there was disagreement over how the flap on top is pushed aside and reset but the rest, meaning the actual procedure, is a computer controlled laser that follows a program based on the preliminary tests of how your eye reflects light. They map the pattern and the computer calculates how to shape the cornea to bend the light so it reflects perfectly. The skill is in the machine. You lie there and the laser burns off your cornea to shape. This isn’t radial keratomy or some other incision based process. There is a benefit to an office with experience but the skill required isn’t shocking.</p>
<p>To be clear, they bounce a light off the back of your eye. They should show you before, which is a fuzzy diffuse ball, and after, which is a tight circle with sharp edges. Experience counts in stuff like measurements for calibration. That is well-trained staff doing it a lot.</p>
<p>Some doctors want to under correct and then adjust. Some prefer to adjust one eye less for reading. Those are issues to discuss. If done to the maximum, your vision is related to the number of cells on your retina. I see 20-10 in one eye becaus that is what it can do.</p>
<p>I had LASIK in early 2000. At that time, the specialist who did it (it was at a cataract surgery clinic) had done 14000 surgeries. I had a few minor complications (a minor infection in one eye and some irritation in the other) and ended up with 20/25 vision (going from 20/400 and terrible astigmatism). </p>
<p>I would second and third and fourth the idea that an office with lots and lots of experience is the place to go. Ask them for their complication rate. The one I went to had a seven-page document listing every single complication they’d ever had and the number of times that complication had occurred. Very reassuring.</p>
<p>Besides the quality of the surgeon (and there are places advertising here in NYC that they do it for 350/eye, have done a tone of them, please! <em>ick</em>), one other piece of advice I got was to go to an opthamologist first who doesn’t do the procedure, to make sure you are a good candidate for the surgery. Even with the advances in techniques and such, there are people who aren’t good candidates (I myself sadly am one of them, have very dry eyes, which causes issues, gotten that from 3 different top level ophthalmologists). </p>
<p>While I am sure many of the doctors doing these things are ethical enough to tell someone they aren’t a good candidate, there is still incentive there to get as many patients as possible. An Ophthamologist who doesn’t do the procedure themselves has no reason to recommend it if they feel it won’t work that well…plus if you do any kind of major surgery, don’t most people get second opinions? Given the value of your eyes, going to see an Opthamologist to see if they see any objections is cheap insurance IMO.</p>
<p>A main disqualifier is a thinning cornea. Easy for a doctor to check.</p>
<p>To be clear, there is old Lasik and newer Lasik. Wavefront Lasik became available in the US in the early 2000’s but was very expensive and not common - because original Lasik was so much cheaper. The names have merged but they are not the same operation. You should be aware of the differences. </p>
<p>A number of companies make the lasers. I think the differences are tiny.</p>