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Lasik's a Procedure, Not Merely a Product

December 06, 1999

I would like to laud your article "Take a Closer Look" (Nov. 8). Public education about Lasik is a very effective means to ensure that patients are informed about the safety issues of the procedure. Lasik is a procedure, not merely a product that you can use a coupon to get a good deal. Lasik, however, is being marketed as if it were a product, making it challenging for patients to understand that it is a procedure dependent on two factors: the surgeon and equipment.

Surgical skill is difficult for patients to assess, especially in the current marketing climate of Lasik. However, this skill largely determines successful outcomes with very low complication rates. How the surgeon learned Lasik is very important. The different expertise level of surgeons, for example, could mean mild to no halos at night postoperatively versus such significant glare that driving at night is impossible.

Patients need to evaluate their potential surgeons carefully. Ultimately, patients should feel that the surgeon and staff have the ability to make them happy.

--BRIAN S. BOXER

WACHLER, MD

Director, UCLA Laser

Refractive Center,

Jules Stein Eye Institute

Los Angeles

*

In response to the article about laser eye surgery, many important points are raised, and it is important that patients understand that Lasik is a surgical procedure with risks and not everyone is an ideal candidate.

The statement that "an experienced surgeon has done more than 1,000 eyes" is made by a doctor performing 75 laser-eye surgeries a week, which is apparently held out by Times staff writers to be a good thing. If a surgeon is doing 75 surgeries in a week, that surgeon spends 32 minutes on each eye. Assuming two eyes per patient, that surgeon spends 62 minutes with each patient. That hour includes the surgical time, the preoperative consent and counseling visit, complete ophthalmic examination and the postoperative visit. This busy surgeon must be working at least 70 hours a week, which they don't. The only solution for the busy surgeon is to "delegate" portions of the patient care. What would you want delegated?

Lasik is ophthalmic surgery, despite the attempt to commercialize it. Experience is important, and so is attention to patients as unique individuals who need and deserve the same quality of surgical care as they expect from any other surgical procedure.

PETER J. CORNELL, MD

Beverly Hills

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