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An Outspoken Few Are Disillusioned With LASIK Surgery

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Most LASIK price packages include any follow-up procedures, Pisacano says, except those from many discount operations, which depend on getting patients in and out fast. "That's why I'm a little leery of those places," she tells WebMD.

Finding a good LASIK surgeon and having reasonable expectations are key to satisfaction, she adds. "Most patients are happy. They have realistic expectations when they go in. You need to find a doctor who will realistically explain things to you and not say you're going to see things 20/20 the next day, guaranteed."

Not everyone is a good candidate for LASIK surgery, she adds. "However, discount places aren't turning them away."

In fact, LASIK is one of the few surgical procedures that are marketed competitively, says William W. Culbertson, MD, director of refractive surgery at the Bascom Palmer Eye Institute of the University of Miami School of Medicine. "When the goal is to recruit people and sell them on the procedure, the potential risks are minimized, and patients who are not good candidates are encouraged to have it."

Further, patients often have unrealistic expectations about LASIK, Culbertson says. "I had a patient who had 20/20 in one eye and 20/25 in the other. She was extremely upset that both weren't 20/20. That's not always possible. But her perception was that she was going to have perfect vision.

"The pizzazz of lasers makes people think they can do anything," Culbertson tells WebMD. "Many patients have friends, family, co-workers who had perfect results. They go in thinking they will have a perfect result. It's a misconception that because it's a simple procedure, there may not be complications, there may not be side effects. ... There are people who have complications even in the best of hands, but the rate of complications is probably higher in certain patients and in less-experienced surgeons' hands."

The less-than-best candidate for LASIK has a large pupil in the dark and needs lots of vision correction, either for nearsightedness or farsightedness and particularly involving astigmatism and preexisting problems with dry eyes, Culbertson says. Side effects like halos at night, dry eyes, and glare may get somewhat better as time goes on, but in some, they persist, he says.

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