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An Outspoken Few Are Disillusioned With LASIK Surgery

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"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.

Age can also be a factor. Vision refraction, which determines how much correction a person's eyes need, may not yet be stabilized in patients younger than 25. The average age for LASIK treatment for nearsightedness is 39; for farsightedness, it's 49. "Medically speaking, you can have it done at any age, as long as there is stability in the refraction," he says.

So whom should you trust with your eyes?

When it comes to choosing a good LASIK surgeon, patients should have a "buyer beware" attitude, Waring tells WebMD. In the hype and price competition, there are "two-eyes-for-one" discount specials. You might "win a free LASIK" in a drawing. In one shopping mall, you can watch LASIK surgery though a storefront window.

"Patients need to have a shoppers' mentality, a critical mind-set, and probably need to interview more than one surgeon at more than one center," Waring advises. "Spend a good bit of time on the Internet, reading up on the subject and the different options.

"The basic warning should be, if it looks too good to be true, it probably is. You need to be critical of discount claims, claims of perfect vision, any claims that don't make sense," he adds.

Talk to your friends, he advises. "If someone you know and trust has been to a surgeon and has had a good result, or who says this doctor is pretty honest, he didn't do my neighbor because his eye wasn't the right shape -- that's the kind of reference that counts. But don't be naive, because you can also have a good result from a crummy doctor."

Also, check out more than one laser center, Waring says. "Sit down and evaluate everything, the center, staff, doctor. There are centers where the patient doesn't see the doctor until 10 minutes before the procedure. ... You need a doctor-patient relationship, in case anything happens."

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