The risks of a dedicated laser eye center

In the last several years, there has been a proliferation of laser eye centers that ONLY do LASIK surgery. In my opinion, this over specialization does a significant disservice to patients.

The LASIK only surgeon will claim in their advertising, that the fact that they only do LASIK is somehow a good thing. But logic and experience shows us the complete opposite. The eye is a complete organ that functions as a unit. And beyond that, it is a part of the whole person and can never be looked at completely separated from the body.

The more you try to separate the eye from the body and then LASIK from the eye in general, the more likely you are to create or overlook problems that should not be. It can be a serious case of “not seeing the forest because of the trees.”

I have often had patients referred to me by LASIK only “doctors” for potentially serious problems of the eye. Interestingly, although these problems were serious pathologies, they were the kinds of things that an eye surgeon would have been trained to treat by the first few months of their surgical residency training.

These problems were things like infections, inflammatory eye conditions (iridocyclitis), cataracts, or retinal problems. I can only speculate as to why a trained eye specialist would refer out these kinds of problems to another surgeon.

One potential problem I see with the LASIK only “doctor” is that for years he only cuts the very surface of the eye and never looks or thinks beyond that point. He may become somewhat rusty in his knowledge of basic problems of the eye and miss things that are important, forget how to treat them, or simply not be up to date on current treatments.

At some chain LASIK centers, the problem appears to be one of availability. In some cases, the surgeon may travel long distances from one location to another and simply not be able to see patients at one office.

Since they are not set up for continuity of care, they often do not have qualified individuals covering them when they are not physically able to see a patient at a specific location. To some degree, it may be a question of payment or reimbursement.

Many LASIK only chain laser eye centers are set up as low cost “factories” and do not want to treat anything that is not a cash payment. Usually, they are not set up to accept medical insurance so if a LASIK patient comes in with something that is a medical problem, it may be seen as a nuisance for which the center cannot collect a fee.  The doctor himself may have no choice in the matter.

If he is simply an employee of a national LASIK chain, the national corporation may have a policy that he should not or cannot treat medical problems both for liability as well as cost issues.

In the long term, lack of comprehensive medical eye care can create significant issues for the patient. I think it is always best for the LASIK patient to have long term follow up with the surgeon who did their LASIK surgery. Over their lifetime, that individual will likely encounter other eye problems and it is good to have established a long term relationship with someone who knows and understands all the nuances of their eye health history.

Eventually, if we all live long enough, everybody develops things like cataracts, glaucoma, or macular degeneration. A history of LASIK surgery can have a big effect on the treatment plan and outcomes especially for cataract surgery or glaucoma.

Even more serious, many significant systemic medical problems ranging from diabetes to brain tumors can have manifestations in the eye. A surgeon that is “LASIK only” may have neglected their comprehensive skills to the point where important, even life threatening problems could be misdiagnosed or missed entirely.

Also, as a general eye surgeon, I feel that my surgical skills are significantly sharper and more up to date than any “LASIK Only” surgeon found at many laser eye centers. Because I deal continually with surgeries that are much more difficult than LASIK, I can apply those skills to my LASIK patients.

As refractive surgery continues to change, I am able to adapt my surgical skills to whatever new techniques and technologies develop. I have too often seen older super specialized surgeons fall behind and be trapped with outdated skills because of an inability to adapt. The more diverse and intricate your surgical skills, the more easily you can stay up to date.

All of these issues can create significant continuity of care or general medical problems for patients. We at Suson Eye Specialists have always striven to stay at the cutting edge of surgical technique and technology with comprehensive ophthalmology as well as Refractive surgery and LASIK.

I believe that this approach, by far, gives the best possible eye care and general health care to our patients today and into their future.


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