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There are some who
have suggested that a doctor's surgical enhancement rate is an indicator of a doctor's surgical ability. That is not necessarily
true. In fact, a higher enhancement rate may indicate a safer doctor
or a doctor who is more concerned about a patient's happiness.
Some doctors and practices
have set policies that dictate when they will provide a patient an enhancement.
A doctor may require additional charges for an enhancement, providing
a financial disincentive for the patient to seek additional care. In
extreme cases, a doctor may refuse to enhance a patient who is able
to see 20/40 uncorrected, even if the patient is unhappy or has quality
of vision problems. A doctor with these types of policies may have a
very low enhancement rate, but may also have a large number of less
than satisfied patients.
Such business policies
can provide a false indication of the true need for enhancements, and
a false indication of the quality of the doctor. Most people who have
conventional or custom wavefront Lasik, PRK, LASEK, or other forms of refractive surgery are myopic (nearsighted, shortsighted). If they are overcorrected, they
become hyperopic (farsighted, longsighted). Refractive surgery for the
correction of hyperopia is significantly different than refractive surgery
for myopia, is less predictable, and has a lower success rate than refractive
surgery for myopia. For these reasons and others, doctors want to avoid
permanent overcorrection into hyperopia.
At the same time, people
with very high myopia tend to regress.
It is not likely that regression would take a person all the way back
to where the patient was before surgery, but regression of 10-30% can
occur. Since this regression is reasonably well understood, it is common
for doctors to deliberately overcorrect a myopic patient into hyperopia,
with the expectation of regression bringing the patient back to the
desired result plano (no
refractive error).
The problem with this
technique is that regression does not always happen and does not always
occur the same from patient to patient, or even eye to eye of the same
patient. The patient may be overcorrected into hyperopia, but not regress
or not regress enough to return to plano. Now the patient requires a
very different form of refractive surgery that is not generally as successful.
A more conservative
doctor may never use the deliberate overcorrection technique. A more
conservative doctor may correct only to plano even patients with high
amounts of myopia, and then enhance the small myopia that returns after
regression. This doctor may have a significantly higher than normal
enhancement rate, but may be actually a safer choice of doctor.
As you can see, enhancement
rates are a very poor indicator of a doctor or surgery's "success" or
"failure". Without knowing the policy and philosophy of the doctors,
an inaccurate conclusion may be formed.
Looking For Best Lasik Surgeon?
If you are ready to choose a doctor to be evaluated for conventional
or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization.
Locate a USAEyes Evaluated & Certified Lasik Doctor.
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