• Evaluation
• Surgeon's fee
• Laser center fee
• Laser company royalty fee
• Post-operative kit with medications
• All follow-up visits
• The cost of any enhancements

There really is quite a lot involved in the LASIK procedure, which utilizes expensive resources and technology. 

In these centers, the evaluation and post-op follow-up is done by non-MD technicians.  A surgeon is only involved for the "shooting" of the laser.  You often don't know who the surgeon will be until just before your LASIK procedure.  Some practices may even charge you extra to see an MD after your surgery

Poor Quality Control:

Some discounters may use poor quality "knock off brand" blades in the microkeratomes, since the best blades are very expensive.

An alarming practice is in the reusing of disposable blades.  With each use of a blade it becomes dull and damaged.  By the time they're on the third patient, microscope studies have shown that it is a blade you wouldn't shave your underarms with.  But, even worse, is the shocking reality that reusing blades between patients, exposes unsuspecting people to HIV, Hepatitis B, Hepatitis C and rabies.

The laser may not be checked for accuracy between patients because this is time consuming.  These are sensitive instruments that my need adjustment in order to get an accurate treatment.  Discounters may forego this in order to sell a higher number of procedures.

"Some Restrictions May Apply":

Detailed questioning may reveal that the "super low price" only applies to the lowest prescriptions possible.  The price will increase rapidly and substantially beyond these miniscule corrections.

Some of the high cost practices are run by a parent corporation, not the doctor himself.  These corporations take out a large chunk of the surgical fee for their profit.  Again, you are paying for this.

This same business model often involves giving a fee to any doctor, or eyeglass store that refers patients to them.  Once again, this money comes out of your fee.

LASIK fees upwards of $5000 are often the result of these factors.  The reality is, you are not getting $5000 worth of LASIK. 

• Make a flap in the cornea

• Remove some cornea with the excimer laser 

The end result:  see well without glasses or contacts. 

The Flap

There are two types of flap making devices: one that hinges the trap door near the nose and one that hinges the trap door under your upper eyelid (down up).  The down-up is created by the best flap making device (microkeratome) available, because normal blinking movement won't twist the flap as it heals.

The Excimer Laser

All  LASIK lasers are "excimer" lasers.  Originally developed to etch computer chips because of their incredible accuracy, they are the key to LASIK refractive surgery.  They quickly and painlessly remove corneal tissue so you no longer depend on glasses or contacts.

Broad beam and flying spot simply refer to how the laser energy is applied during treatment.  To claim that one type is better than another, for all patients is misleading and may only serve to promote whatever laser type in which a doctor has a financial interest. 

I have all laser types at my disposal, and will use only what is best for each individual patient.

"Super-duper Scan"   Some surgeons are trademarking silly names for their LASIK procedures that do not reflect any difference in technology.  BEWARE.

Tech Talk is phrased in a way that implies improvement and an advantage over any other existing technology.  This may be false and misleading.  Did those sneakers really make you run faster and jump higher?

For those patients who are good LASIK candidates now, the answer is NO.  LASIK refractive surgery will remain the preferred method of surgically reducing dependence on glasses and contacts; improvements in LASIK technology would be for those patients who are not good LASIK candidates now or who have special problems.  

Just because there will be a new car model out next year, doesn't mean that you have to walk to work today.