Who will perform your preoperative work-up?
Will it be an optometrist or technician, and if so, when will the ophthalmologist review the findings and discuss them with you? Will your surgeon review all of the tests that were performed before the day of surgery?
Does the surgeon regularly practice medicine in the community where your surgery is being performed?
In some cases, surgeons have a practice in another state, which means you may not have access to your doctor if there is a post-operative complication.
What is the size of your pupils at night?
Get a number in millimeters. How does this number compare to the corrective zone of the laser in millimeters? If your pupils are larger than the area being treated, you might expect visual disturbances at night, the extent to which may be hard to quantify before surgery. You should talk to your doctor about the risk you face.
How will the LASIK flap be made?
Some surgeons use a mechanical microkeratome (the device used to cut the flap on your eyes) and rely on metal blades. Other surgeons create a flap with a laser instead of a blade. If your doctor is using blades, will new blades be used in the microkeratome for each eye? A new blade means a cleaner cut for you and therefore fewer visual disturbances. You want new blades for each eye.
Are your corneas thick enough for the planned surgery?
After the surgery, you should have at least 250 microns remaining in the corneal bed, preferably more. Are your corneas thick enough for any re-treatment that might be necessary?
Do you have dry eyes?
Dry eyes are the most common complaint after LASIK surgery. If you have dry eyes even before LASIK, you are at risk for a permanent and severe problem following LASIK surgery. If you have dry eyes, then first work with the doctor to treat the problem. If the problem cannot be treated, you are probably not a good candidate.
Do you have an inability to wear contact lenses?
This can be a red flag for a very significant problem often overlooked by LASIK surgeons. An inability to wear contact lenses may be due to either a dry eye problem or an abnormally shaped cornea. Both are problems that make LASIK surgery either inappropriate or highly risky.
Have you met your surgeon at a preoperative visit before the day of surgery?
Sometimes patients do not meet their surgeon until the day of surgery, when the surgeon is rushed. The day of surgery may be too late to have an in-depth discussion about the surgery with your doctor. Who will follow your care? In centers where optometrists, and not ophthalmologists, follow your care you may get less than appropriate treatment. Many centers are staffed with optometrists because they are set up on a business model that places money over safety.
After your examination, ask your surgeon whether there are any findings or conditions that make you a less than ideal candidate for surgery. If there are, ask your doctor to tell you what additional risks you face because of this.
NOTE: BEFORE SURGERY YOU WILL BE ASKED TO SIGN AN INFORMED CONSENT DOCUMENT, WHICH IS A MULTIPLE PAGE DOCUMENT THAT LISTS MOST OF THE RISKS OF LASIK SURGERY. THIS DOCUMENT IS PREPARED TO PROTECT THE DOCTOR IN THE EVENT THERE IS LITIGATION. WHILE THE DOCUMENT LISTS THEORETICAL RISKS, IT IS NOT DESIGNED TO GIVE ADVICE THAT IS PARTICULAR TO THE PATIENT.
IF YOU DO PROCEED WITH SURGERY, WRITE DOWN ON THE INFORMED CONSENT SHEET WHAT QUESTIONS YOU ASKED AND WHAT YOU WERE TOLD. THIS MAY PROTECT YOU IN THE EVENT YOU WERE GIVEN BAD ADVICE BY THE DOCTOR.
Have you considered a second opinion before permanently changing your eyesight with this elective procedure?