Competition is fierce in the refractive surgery market. Everywhere you turn, you hear something about the wonders of laser surgery.

In southern California, where a laser center sits on just about every corner, we�ve distinguished our center from our competitors by consistently providing our patients with exceptional care. Instead of spending a lot of money on media advertising to bring patients into our refractive laser center, we rely on word-of-mouth referrals from satisfied patients and from optometrists, who find that their patients receive the highest quality of care at our facility.

One of the keys to our success is giving our patients all of the information they need to make an informed decision about refractive surgery.

We call this creating refractive motivation. Here, we�ll show you how you can establish the same level of excitement and open-mindedness among your patients.

We recommend that you start "motivating" or informing interested patients during the first patient communication on refractive surgery and that you continue the process during every subsequent patient contact. Cover the following points in your discussions:

� Experience. Unlike photorefractive keratectomy (PRK), when the computer does most of the work, the success of laser-assisted in situ keratomileusis (LASIK) depends on surgical skill. We inform our patients that our surgeons have been credentialed in LASIK through a special course, and that each staff member has been thoroughly trained and credentialed, as necessary. We also tell them that we�ve performed as many or more LASIK procedures than any facility on the West Coast, producing consistently exceptional outcomes.

� Equipment. We tell patients that we have the finest equipment available. Our system includes the Summit and the VISX Star lasers, which are the only two FDA-approved lasers in the United States. We also have the Technolas and the Nidek lasers in our system, which we use for studies and surgeries outside of the United States.

� Co-management. We explain to our patients that while our surgeons and staff will provide them with the best surgical care possible, their optometrists know their eyes the best and can provide lifelong eyecare. Our goal is not only to receive patients from co-managing optometrists but also to build co-managing optometrists� practices by directing new patients to them. This encourages patients to accept the trip to the surgeon as they would any other referral for care.

We have professional relations representatives who focus solely on building our relationships in the optometric community. They provide optometrists with co-management manuals, patient education literature on refractive surgery and signs for their offices. Our staff optometrists communicate regularly with co-managing optometrists on the status of their patients on surgery days. We also have a professional relations priority phone line specifically for doctors to call in to schedule their patients and to ask questions.

� Risks and benefits. Patients learn about the refractive surgery procedure from discussions with the patient counselor, optometrist and surgeon, and from patient education material. We want them to understand the risk factors involved and to feel confident that they�re making the right decisions. We don�t try to convince patients that we can get them to the exact correction they have with glasses or contact lenses. Patients who aren�t willing to possibly sacrifice one or two lines of vision and who don�t have a problem with their current visual appliance are encouraged to continue with their current form of vision correction.

� Options. We inform all patients that refractive surgery is just one option for the treatment of refractive error. We advise those with corneal diseases and severe dry eyes that LASIK surgery may not be their best option because of variability in surgical healing and in outcome. We advise monocular patients that they can be treated if they understand that, while their risk isn�t any higher than that of binocular patients, a poor outcome would be more devastating.

Once a patient decides to undergo LASIK, we review the other options he must consider. For example, if the patient is older than 40, he might opt for monovision. This can significantly reduce his need for reading glasses. We find that about 80% of our patients who try monovision like it.

Patients must also decide whether to have both eyes done at the same time. About 99% of our patients choose bilateral surgery because of the low risk of complications in the hands of an experienced surgeon.

In summary, we�re dedicated to providing the safest, most complete vision-enhancing treatment. We succeed because we have experienced surgeons and staff, the best technology, a large network of skilled optometrists, and because our patients are prepared to make the choice that�s right for them. OM

Here are the answers we provide to the questions patients most frequently about LASIK. Tailor your responses to the individual needs of each patient.

� Is the correction permanent? LASIK surgery is considered

permanent. Your distance vision should remain the same, but your up-close vision will change sometime after the age of 40.

� How much time off from work will I need after the surgery? Will I have any restrictions? Most patients only need to take 1 day off from work. You won�t be able to wear eye makeup for 10 to 14 days and you must be careful not to rub your eyes for 3 months after the surgery.

� Can I wear my contact lenses up until my surgery date? No. It�s very important to remove contacts for a specified amount of time before surgery and before the pre-operative exam with your optometrist. The minimum requirements are:

• Soft daily disposable lenses: 3 to 5 days
• Soft toric or extended: 5 to 7 days
• Rigid gas permeable or hard lens: 3 to 4 weeks minimum.

� How long does the surgery take? Will it hurt? LASIK surgery takes about 7 to 10 minutes per eye. You won�t feel any pain during surgery, but you will feel some pressure when the

surgeon pressurizes (or hardens) the cornea to make a successful flap. This sensation only lasts a few seconds. You�ll also be aware of the surgeon touching your eye, but this doesn�t hurt.

� When do I return to my optometrist? We�ll see you the first day after your surgery. After that, as long as you�re healing

properly, your next appointments will be with your optometrist at 1 week, 1 month, 3 months, 6 months, 12 months and 24 months after your surgery.