Other important considerations are the immediate and long-term risks and recovery time, as well as the benefits of each procedure for specific refractive errors. Optometrists also should discuss the recovery time for each procedure and the visual requirements for the patient's occupation. If they're willing to trade off a little bit of crispness for the convenience and the ability to be independent, then they are going to be thrilled. If they continue to compare their results to their preoperative vision, particularly with rigid gas-permeable contact lenses, they are almost universally going to be disappointed. Another potentially troublesome candidate is the presbyopic patient, Dr. Baker said.
Presbyopes require careful counseling regarding their refractive surgery options.
Monovision generally works well for patients who are successful monovision contact lens patients. If a full distance correction is requested, patients should be carefully educated about the need for near correction after the procedure. Despite careful counseling, patients may still come in and say, 'My near vision is horrible. To protect the comanaging optometrist in these situations, Dr. Baker suggests developing a consent form, even if the surgery center has its own. Optometrists also should remember that not every patient will be a candidate for surgery.