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Health plans refuse coverage for laser eye surgery

Health insurance companies rarely pay for laser surgery that corrects vision in nearsighted, farsighted and astigmatic people. They consider it cosmetic surgery, placing it in the category with breast implants and facelifts. For example, according to CIGNA, "Laser surgery to correct nearsightedness is an elective procedure. There is no medical reason to have this surgery. Nearsightedness does not threaten your vision or your health."

Yet, despite the surgery's average price tag of $1,000 to $2,500 per eye, consumers are clamoring to have it done — and willing to pay for it themselves.

"Flap and zap"

The most popular surgical technique for vision correction is LASIK, which stands for "laser in-situ keratomileusis." The doctor cuts a tiny flap on the cornea and then a few pulses from a laser remove the area underneath the flap. This procedure corrects the refractive errors responsible for the most common vision problems such as nearsightedness.

Similar in results is PRK (photorefractive keratectomy), which uses the same laser to reshape the cornea.

Since health insurers don't cover cosmetic laser vision correction, don't expect them to provide follow-up services related to the surgery or to fix someone else's mistake. Pre-operative and post-operative visits should be covered in most surgeons' fees.

You can see clearly now — maybe

95.4 percent of LASIK patients are satisfied with their new vision.

According to American Society of Cataract and Refractive Surgery, 95.4 percent of LASIK patients are satisfied with their new vision, and 16.3 million patients worldwide have elected the surgery.

When it doesn't go perfectly, LASIK has been known to cause dry eyes, ghost images, starbursts and halos, scarring, pain and poor contrast sensitivity. Many more post-laser patients will still need glasses, perhaps for reading or night-time driving, or further surgery as the shape of their eyes change through the normal aging process.

The Eye Surgery Education Council says that severe complications occur in only about 1 in 5,000 LASIK surgeries, such as diffuse lamellar keratitis (DLK), which happens when foreign cells get under the flap and cause symptoms such as blurred vision, sensitivity to light and the sensation that there's a foreign body in the eye.

Not everyone performing laser eye surgery offers the same level of skill and post-operative care. In addition, if you're thinking of crossing the border into Canada to have your vision corrected because the operation is cheaper there, remember that you would have to return to Canada for follow-up care, or find another doctor in the United States and foot the bill yourself.

The FDA offers extensive information about LASIK eye surgery. The agency urges prospective patients not to choose a laser center on the basis of price alone. Also, be sure to thorougly read the patient handbook provided by the doctor and to discuss the doctor's outcomes, successes and complications.

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