If you read yesterdays post you are up to speed on wavefront technology. OK, so far so good. It seems wavefront correction improves quality of vision after laser eye surgery. And indeed clinical trials confirm that vision results are much better after laser makers added the ‘wavefront‘ upgrades to their machines.

For example, the American made VISX lasers, used at all Optical Express laser clinics, have much better results when using their wavefront upgrade from 2002. I would not recommend having laser eye treatment today in 2008 without choosing the wavefront package on that system.

Wavefront laser eye surgery - is it the whole truth?

So now you want ‘wavefront‘ in your laser eye treatment! Of course, as the results are better. But when laser manufacturers introduced ‘wavefront’ they actually bundled in other improvements which may account for much of the jump in results! They just didn’t tell you. Why? Because it is complicated to describe all these improvements to someone who isn’t familiar with the technology – such as you, the patient!!

And honestly, I bet the sales people at most clinics talking on the phones who want to sell you a consultation don’t really understand it either! However, they have been trained to explain the wavefront part only, as something like this… “we take a scan, a unique fingerprint, of your vision and the use that fingerprint to perfectly correct your vision“. Go on, call them and check it out!

But for you, as a patient or customer, don’t really care about which part of that technology is helping you the most, you just want great vision, right?

So don’t let clinics blind you with science about wavefront scanners, wavefront maps, measuring hundreds of points of light or how much better their scanner is than other clinics scanners. It is usually marketing spin! Take it all with a pinch of salt.

However, you should choose the ‘wavefront option’ because within that package are the big improvements in laser eye treatment over the past several years. The success of surgery may actually be less to do with the true wavefront technology that has helped astronomy, but rather other improvements that may be confusing to patients but get wrapped up in the marketing of wavefront LASIK.

We come back to ethics again here. Is it ethical for some clinics to still sell ‘non-wavefront’ laser eye surgery technology that was replaced back in 2002?

For my own clinic, we do not offer non-wavefront treatments at all. None at all. I want every one of my patients to have the benefit of the newer laser eye surgery results. So we made it very affordable. In fact, we charge less for wavefront LASIK than other clinics do for their ‘entry level’ lower price non-wavefront LASIK. Really.

That’s my plug for FOCUS done! So, do choose wavefront but don’t pay more than you have to!

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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!

How to different laser eye surgery clinics charge for treatment? It can be confusing to understand different prices and messages from various clinics.

For LASIK pricing, there are two common ways to charge. The first is 1 price for all prescriptions – in effect the lower prescriptions are subsidising the higher more difficult cases. The second method, used by ourselves and some others, is to charge based upon the prescription.

So the easier the treatment and the simpler the case, the less that patient pays – and vice versa. This seems the fairer way overall.

Also, younger patients (who are mainly short sighted) generally have less money and so can more easiy afford to have laser eye treatment with FOCUS, as their prescriptions come in at a lower rate. Long sighted treatments are more complex (we specialise in these, unlike most clinics) and are more expensive. These patients are typically in the 40s and 50s and often can often afford a bit more.

I know it sounds rather like Robin Hood(!) but this allows more people to get a superb level of treatment with a very experienced surgeon, with lots more time in a relaxed clinic, away from a high-volume quick turnaround setup. For example, one of the laser chains has surgeons performing up to 40 laser eye procedures per day. At this level, the chances of the surgeon making a mistake increases. For any of us, if we are rushed at work we cannot do our best. We believe it is better to have fewer patients and spend more time.

I really have tried to make top-end ‘Harley Street’ laser eye treatment available to more people, hopefully in a fairer way (we are actually next door on Wimpole Street). I wish everyone with glasses could afford to come for treatment but, if you see my next post, this is not likely to happen.

The most common reason I hear from people who have not yet decided to go for laser eye correction is that they are cautious and worried that something might go wrong. This is very understandable.

LASIK eye surgery is not for everyone. Some people are very happy with glasses. Some like to have a designer accessory prominent in their appearance. Many people would definitely choose to have laser sight correction if someone could ‘guarantee’ that nothing would go wrong.

LASIK eye treatment has, in fact, become a very safe procedure BUT (there’s always a but!) you need to have certain boxes ticked before you go ahead.

The results you will get, and live with, will depend on four factors:

1. The laser technology used – your surgeon cannot get better results than the laser can deliver
   QUESTION FOR YOU: Which laser is the best? 

    

2. Your surgeon – the laser will only perform as well as the surgeon ‘driving’ it! And even then, never better than the manufacturer made it capable of – see point 1
   QUESTION FOR YOU: How can I know who the best surgeon is? 

    

3. The clinic – will they take good care of you before, during and especially after your treatment?
   QUESTION FOR YOU: How can I select the best clinic? 

    

4. The price you will pay - you don’t always get what you think you are paying for
   QUESTION FOR YOU: How much should I pay for LASIK laser eye surgery – if I pay more, will it be better or safer?

Tune in again next week to see the answers to these questions! The truth is out there! (old X-Files fan – sorry!)

I keep getting asked about how to choose a good laser eye surgery clinic and what to look out for when considering LASIK.

So, as you may know, there are FOUR key things to look out for when considering laser eye surgery and picking out a laser clinic for vision correction:

1. Laser technology used (Your surgeon CAN’T get better results than the laser can deliver)
2. Your surgeon (Your laser will only perform as well as the surgeon ‘driving’ it! And even then, never better than the manufacturer made it capable of – see point 1))
3. The clinic itself (Will they take good care of you before, during and especially after your treatment?)
4. The price you will pay (You don’t always get what you think you are paying for)

So, as requested, I will posting a map of all the laser eye surgery clinics in the UK, PLUS which laser they use, PLUS what results those lasers are capable of delivering!!

The truth is out there… and will be here very soon!

Optimax, one of the UK’s big 3 laser eye chains, has made a significant price hike for their wavefront LASIK treatment, the UK’s most popular type of vision correction.

Patients will now pay an additional £480 to have both eyes correct with blade free wavefront LASIK. Bilateral (both eyes) treatment has risen from £2,890 in August last year up to £3,370 today.

One of the big changes in the laser eye treatment industry is the battle for a low headline price. Optical Express lead the way with a “from £395” price headline with a huge marketing campaign across the UK. Optical Express have raced ahead over the past few years and now do more treatments than any other UK laser provider.

Optimax has responded to the challenge by dropping their headline price to match OE’s at £395 per eye (Epi-LASEK).

However, you have to look closely to see what is on offer. For Optimax, £395 will not get you either LASIK or superior wavefront vision correction. For that you will have to pay £1,290. The £395 headline is for non-wavefront surface laser which lacks the comfort and rapid recovery that makes the LASIK procedure the most popular amongst patients.

And if you want the advanced blade free Intralase laser rather than a blade, there is an additional £395 (up from £300 per eye last year) to make an Optimax price of £1,685 per eye or £3,370 for both eyes.

Optimax prices in blue as of April 30th 2008. You can compare to prices from August last year just below, in green. You can see how all prices have risen, except for the Epi-LASEK entry price of £395 per eye, which does not include wavefront advanced optics.

A complaint we hear from LASIK patient is just how much more the price escalates to once you attend for a consultation, above the advertised ‘from’ price.

As I wrote about in a recent post, Ultralase have also raised their prices to £1.945 per eye for blade free wavefront LASIK vision correction.

Both Optimax and Ultralase charge a fixed fee for all prescriptions, while Optical Express have a sliding scale based upon the strength of the prescription glasses correction required; the worse the vision, the higher the cost.

The patient attending Optical Express will find typically 3 jumps in price:

1. Additional cost for a prescription above the mild prescription of the headline price
2. Additional cost for wavefront correction ( an upgrade issued back in 2002 by VISX)
3. Additional cost for Intralase blade free dual laser correction

So overall, the UK trend is to offer a low headline price, while actual LASIK prices are on the increase.

I should add here, humbly, that FOCUS Laser Vision prices are against the trend, and we have lowered our advanced blade free wavefront correction price to the best available in the UK. However, we are a specialist clinic serving London and the South-East and without a nationwide footprint. Sorry to the rest of the UK! Blade free ‘Intralase-type’ wavefront LASIK starts at £595 per eye and most patients are not spending much more than around £1,000 per eye for this advanced treatment at FOCUS. OK, personal plug over!

How much do you want to pay for LASIK eye surgery? Most people are voting that LASIK laser eye surgery prices should be under £1,000 per eye. If you haven’t yet voted, look over to the lower right hand side bar and have YOUR say!