Carolina Cornea

LASIK eye surgery cost: three determining factors


The cost of LASIK is determined by three factors – surgeon involvement, laser software used to change the shape of the cornea, and laser versus blade corneal flap.  It is important for each patient to evaluate these three factors which influence lasik eye surgery cost as not all LASIK procedures are the same.

Surgeon involvement

– The amount of care that the surgeon provides is very important in determining the cost, and potentially the safety, of your procedure.  There are basically two models: co-management and total surgeon care.  


The co-management model means the surgeon performs the surgery and other doctors, usually optometrists, examine the patient at all other visits – both pre and post-operatively.  Often the LASIK surgeon lives out of town and comes to the LASIK facility periodically to perform procedures.  Having the pre- and post-operative visits performed by an optometrist is less expensive and referring optometrists are typically paid 20% of the surgical fee, thus enhancing surgical referrals to the LASIK facility.


Total surgeon care means the LASIK surgeon participates in your care at every visit: pre-operative evaluation, the LASIK procedure, and all post-operative care.  Many patients prefer this higher level of professional service to assure that they have the most highly trained individual providing every aspect of their care.  It makes sense that if the LASIK surgeon is generating the initial numbers at the pre-operative visit that will be used to later correct your vision and that same surgeon examines you at every post-operative visit, you will have a safer more accurate LASIK procedure. At Carolina Cornea, we are committed to Total Surgeon Care because your best vision, and your safety, are our top priorities.


Laser software used to change the shape of the cornea

– Several companies make excimer lasers used to ablate or change the shape of the cornea to correct a patient’s refractive error and allow them to see better without glasses.  There are four different software types – standard, topography guided, wavefront optimized, and custom wavefront.


Standard or traditional software means the surgeon essentially programs the laser from the patient’s glasses prescription, though there is some flexibility in changing the diameter of the zone to be treated on the cornea.


Topography guided software uses a combination of traditional or standard as well as measurements generated from the corneal shape.  It requires nomogram adjustments according to the individual surgeon’s experience.  Correction of irregular corneal astigmatism is still in its early stages.


Wavefront optimized software means that a pre-determined average wavefront combined with the standard or traditional programming of the laser is used for the patient’s correction.  Wavefront describes a type of measurement of the refractive error of the visual system that combines higher order aberrations or the glasses prescription with lower order aberrations or the individual fingerprint of the refractive error.


Custom wavefront software measures each individual patient’s wavefront (including both lower order and higher order aberrations) and uses these custom measurements to program the laser correction of the patient’s refractive error. This high-level of customization naturally produces better results for patients. Custom wavefront LASIK is considered the gold standard for laser vision correction and is what we offer here at Carolina Cornea.

The making of the corneal flap

– There are two ways to make a corneal flap.  

The first is with a microkeratome, which was considered state of the art until about 2005.  The microkeratome uses a blade vibrating at high speed as it passes across the cornea.  This method is considerably less expensive than using a femtosecond laser, but the complication rate is higher than a laser flap.

At Carolina Cornea, we use femtosecond laser technology. The first laser flaps were made with the Intralase and around 2005 this femtosecond laser technology advanced such that laser flaps could be made more safely than blade flaps.  Advances have continued and several companies now make femtosecond lasers for corneal flap making.  Of course, this more advanced technology is the most expensive, but it also produces the best results with the least complications.

See All Posts