Important Questions To Ask Your Eye Surgeon
To undergo Lasik eye surgery, or similar ophtalmic eye operations that use laser or refractive surgery is an important change to the eye. Just as you would not allow an unqualified back yard mechanic to fine tune a Ferrari, you should make sure that your eye surgeon is qualified and knows what he is doing. It's especially important that the surgeon has the necessary experience and that the eye surgeon operates regularly. It's not so important if the system used is Lasik, Lasek, Epi-Lasik or PRK. Althouhg it's important that the clinic uses modern equipment, the surgeon is much more important!
Thus it's a good idea to ask your prospective surgeon some questions about the procedures that will be employed, about his qualifications and operations, as well as about the surgeon's person. Naturally, you will need to ask for proof of his statements, and you might want to ask third parties as well. Use your normal everyday common sense, don't be gullible and you will most likely find a qualified and trustworthy eye surgeon.
If you know that you need special exams, that a particular surgeon can not provide, either go to an other clinic alltogether, or insist, that the examination take place in an other clinic / facility. Don't skip a necessary test or examination before undergoing lasik surgery!
A good place to get detailed information about Lasik is the official governement site: http://www.fda.gov/cdrh/lasik/.
Important Questions To Ask Your Eye Surgeon Part 1
Surgeon's Operating Experience
As allready mentioned, but this is so important, let's repeat it here: The surgeon and his experience in the specific procedure that will be applied in your case, with the same equipment as will be used, makes all the difference. It's great to have the newest technology, but the man or woman who must master the technology and makes the decisions is your surgeon. He/She must be experienced and must perform the very same procedure regularly. So the first questions to ask, before you go any further, are these:
You need to know for how long your surgeon has been performing lasik or similar surgery. The eye doctor's answer should indicate that he has been performing refractive surgery for a minimum of two to three years.
Then follow up with the next question: You need to know, how many refractive procedures, not counting any mechanical surgeries (i.e.: RK Surgery = Radial Keratotomy - Deep incisions made in the cornea to change refractive error; ALK surgery = Automated Lamellar Keratoplasty - a thin layer of cornea is removed to change refractive error; AK surgery = Astigmatic_Keratotomy - similar to Radial Keratotomy) your surgeon has performed, since he/she started to do refractive eye surgery? Your prospective eye surgeon's answer should indicate that he has been performing 500 or more refractive surgery procedures, and that he/she has been performing at least 200 of these operations in the last year.
Once you have had your examinations and the surgen has told you how your specific surgery will be handled, ask him/her how many patients who have the same refractive error as you have, have been treated by him/her with exactly this method and the same equipment. The eye surgeon's answer should indicate that he has been performing at least 100 operations of the same type and for people with the same indications as you show. Make sure you pay close attention to this particular answer! Refractive surgery moves quickly, and new procedures are developed all the time. You don't want to become his guinea pig for a new system or equipment. Even if the eye surgeon has an experience with thousands of operations on other equipment or procedures, he'll first need to get experience - preferably not on you...
The minimal experience for your eye surgeon that you look for can be summed up with this formula: 500 total, 200 last year, 100 my case = 500 - 200 - 100
Outcome Of Lasik Eye Surgery
Let's first explain how your vision is measured with the Snellen test, that's the chart that we all know and the test that we have certainly all performed at least once in our lives: The Hughe 'E' on top, and then consecutively smaller letters further down. The chart is usually set up on a wall 20 feet away.
To determine what the vision of a person is, two numbers are used, separated with a slash.
'20/20' means that the person is able to see a letter from 20 feet away with the same clarity that a normal sighted person can see it. (20 feet for me, same as 20 feet for normal sight).
'20/40' means that the patient can see soemthing 20 feet away with the same clarity that a person with normal vision can see when it's 40 feet away. Means before an item becomes clear this person needs to approach a lot closer. This is worse than normal vision.
'20/10' means that the patient can see soemthing 20 feet away with the same clarity that a person with normal vision can see when it's 10 feet away. Means an item becomes clear way before normal people can distinguish details, eagles eyes! 20/10 is better than normal vision.
Ask your eye surgeon what the percentage of people is that reach 20/40 vision or better. It's the accepted norm, that about 90% of the patients reach this value. If you are told a higher number, you should ask for proof. Follow up with a second question and ask how many reach normal vision (20/20), or even better, after the operation. The normal percentage for this outcome is about 50%.
Also be aware, that if today before the operation your own correction in diopter corresponds to one of the conditions below, the probability to reach an uncorrected normal vision of 20/20 is lower, and you are certainly not an ideal candidate for for refractive surgery. If your eye surgeon tells you differently, look for an other one.
- Higher than 10.00 diopter (myopia = you are unable to see objects far away, also called nearsighted or shortsighted)
- More than +3.00 diopter (hyperopia = you are unable to see near objects, also called farsighted or longsighted)
- Astigmatism greater than 2.00 diopter (astigmatisme = uneven radius of the cornea that results in distorted images)
Problems After Lasik Eye Surgery
Not every Lasik or refractory operation is sucessful after the first time. You want to know what the success rate of your prospective eye surgeon is. Small problems are usually resolved in the first six months, so ask what the reported complications are six month after. Specifically ask about not only the clinical complications that the eye surgeon himself diagnoses, but also about subjective concerns of patients. That can i.e. be halos, starbursts, dry eyes or other complaints.
It's generally accepted, that the number of patients that have complaints after 6 months are about 3%, a relatively small percentage. If your surgeon is vague and seems to hesitate to give you hard numbers, or even talkes of none, be careful. Also if the number is significantly lower, ask for proof, just like in any other profession or procedure, total perfection is impossible...
One way of keeping this number very low is by keeping complicating cases away and only accepting easy surgery. Also, some patients are simply not suited to refractive surgery and need to be told so, becaus it would cause more damage than help and a good surgeon will not hesitate to decline an operation in such cases. So an other very good follow-up question is to ask, how many patients are turned away by your surgen. He will certainly not volonteer this number, but as long as you don't get the annswer 'None at all', this OK. If however you're told 'none' then the red warning lights must go on immediately!
Forward to part 2 of the questions for your Eye Surgeon
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