Following on from yesterdays post on some key LASIK and laser eye surgery questions, lets look at these:

• Do clinics try to sell you on the most expensive treatments?
• Are these expensive treatments no better than the cheaper ones?
• Is there really any difference between blade LASIK and the newer (more expensive) blade free dual laser option?

The main point here is about more expensive laser eye treatments over cheaper ones. What is the difference?

When you buy anything you normally have a choice of quality and price, for example an HD television or more basic one. Or a Mercedes over a Fiat Punto. We all understand that more money usually gets a higher value brand and clinics typically price the surgery this way too.

There are two ways you can upgrade your treatment: (1) upgrading on the quality of the final vision (you will see better afterwards) and (2) improving the safety and accuracy of the eye surgery. These are upgrades on what used to be the best treatment only a few years ago, which is known as non-wavefront LASIK and using a blade device to cut a thin flap in the surface of the cornea (the clear window at the front of the eye).

Let’s look first at spending more to get better quality of vision than the older ’standard’ treatments (which are STILL available at most clinics, not at my centre – FOCUS, by the way, although there is a good case to abandon this older technology). The high street chains (Ultralase, Optimax and Optical Express) all offer two levels of surgery for quality of vision.

The basic cheaper treatment is called by various names but all are what are termed ‘Non-Wavefront’ surgeries. For example Ultralase call it just ‘laser eye surgery’, Optimax and Optical Express refer just to ‘LASIK’.

The higher quality, better vision treatments all come under what is called ‘Wavefront’ laser eye surgery.

‘Wavefront’ simply refers to a technology that is claimed to offer higher-definition vision, especially at night time, which was introduced several years ago.

Just to confuse you there are different names, again depending on which clinic you visit! For example, Ultralase call this ‘ULTRALASIKplus‘, Optimax opt for the simpler ‘Wavefront LASIK‘, while Optical Express go for the mouthful of ‘Advanced CustomVue Wavefront LASIK‘. Other independent clinics use various names.

At my own clinic FOCUS Laser Vision, we only offer the higher quality vision ‘wavefront’ laser eye treatments. You cannot get non-wavefront eye surgery with us.

Please note that paying more at one clinic doesn’t mean you get better surgery than at another clinic. You need to look at what you are paying for. For example FOCUS Laser Vision charge less for advanced wavefront correction than most other clinics do for older technology non-wavefront treatments. Blowing my own trumpet here, I know! But paying more does not always equal getting more. More on this later.

Kay also asked in her mail about the ethics of treatment offerings and we will cover that topic in the next blog postings. Basically, is it ethical to offer lower quality treatments when newer higher quality ones are available? No-one cares about this for other products and services (is it ethical to sell Fiat Puntos when Mercedes are available?) but it can be a hot topic in healthcare. I will write on this subject during the coming week. And I will welcome your comments!

OK, but are these ‘wavefront’ treatments really better than ‘non-wavefront’? Come back tomorrow to get the truth!

There are three main treatment choices for anyone thinking of having laser eye surgery. But which one will be right for you?

The final choice will be determined between you and your laser eye surgeon. BUT, of course, you have the eyes and your surgeon has the expertise so you will be heavily influenced by what the doctor or another clinic staff member says. It will be better to be prepared. With just a little knowledge you can be actively involved in making the right choice.

I will outline the 3 main options to help you have an informed discussion when the time comes to select which approach is best for your individual eyes. After all, you only have one pair so you want to get it right.

You will be overwhelmed at first by all the terminology, treatments and brand names. Don’t worry. There is no need to be blinded by science or some of the frankly misleading marketing information that is out there.

Firstly, whichever of the 3 treatment types (more on these coming in a couple of days in part 2) you go for, you must go for the wavefront option. The wavefront (or custom) technology has made a huge improvement in vision success rates with many more people getting 20/20 sight or even better.

Different clinics use different names for this technology: custom, wavefront, wavefront guided, wavefront optimised, CustomVue.

Many clinics will charge you more for wavefront based treatments over older non-wavefront options. Is it worth it? Definitely.

Back in 2000 when we were doing LASIK without wavefront, the benchmarks for success were getting 65% of patients to 20/20. In 2008 we expect more than 95% of patients to see 20/20 or better. This improvement has come from better technology, in large part from custom or wavefront based corrections.

Also wavefront laser eye treatment will give better vision at night or in low light situations. Patients will notice less halos and glare from light sources such as car headlights. It is like buying a more expensive camera with a much, much better lens.

This is the year 2008, so get the best current technology for your sight correction – you only will have this done once and you will live with the results for the rest of your life. Think about the computer you had back in 2000 and what is now available in 2008 – that is the level of difference in laser technology too. No brainer, really.

If you can’t afford the price, either don’t have it done yet and save up until you can afford it, or think about financing.

So if you go to Optical Express, go for the more expensive CustomVue wavefront version. Without it, the results really are not at a level that is satisfactory in 2008. If you go to Optimax or Ultralase, pay and get their wavefront guided option.

If you go to FOCUS Laser Vision, wavefront is already included in the quoted price. They don’t do any non-wavefront treatments.

Come back in a couple of days to read part 2 where we will finish this post by looking at safety and healing in laser eye surgery.