We finally went to our consultation with Dr. Hyver. The first thing we noticed immediately was that Dr. Hyver's office was a busy place. He has three offices which he bounces around. This tells me that his volume is high. There was already three individuals waiting there when we arrived. Based on that evidence, he is clearly more busy than the other two doctors we went to.
On the walls were 49ers posters, namely Patrick Willis and Joe Staley. As a 49ers fan, this has a weird comforting draw to it. If P52 and Joe Staley got LASIK with Dr. Hyver, then he must be good! Isn't marketing amazing?
After a good wait, we were finally on our way for the measurements on my wife's eyes. The first technician was dull, didn't say hi to me nor offered me a chair. She was very robotic and mechanical, "do this," "move here," "blink." Then boom, we were moved to another room where an optometrist further measured my wife's eyes. This guy was more lively and I can see that he enjoyed his job more. Finally, we were given a page to read about preparation for LASIK. Once we were done reading, we were lead to the doctor who probably buys more KNBR time than anyone else: Dr. Hyver.
My impression of him was that he has a cool calm demeanor, easy to speak to, and not cold as some Yelp reviews may indicate. He did not rush his answers but instead spoke slowly and calmly, unlike the other doctors who spoke like they had a flight to catch. It's a surprise that he is the easiest of the three doctors we've seen to speak with. It's only when we started asking questions that the highs turned low.
Question 1: On your website, it mentioned that you will perform tests to determine if wavefront-optimized or wavefront-guided procedures would be appropriate? His answer? "Well, our website is a little old and we haven't updated that yet. We have found that optimized work very well for the majority of our patients." In other words, he doesn't test for it and he doesn't provide "custom" or wavefront-guided procedures.
This is from his website word for word: In addition to Wavefront-Optimized LASIK, Dr. Hyver also offers Wavefront-Guided LASIK on the WAVE® Eye-Q laser. In cases where the patient has an unusual higher-order aberration map, Dr. Hyver may recommend Wavefront-Guided rather than Wavefront-Optimized LASIK. However, the vision results of these two technologies are essentially the same, with the Wavefront-Optimized solution producing a slightly higher rate of patients seeing 20/16 (i.e., better than 20/20).
Wavefront guided procedure requires an extra Allegro Analyzer which costs more money, 3 more of these for each of his offices, and the extra consultation required to to analyze your wavefront and set it. That cost time and money.
Question 2: How many years have you had your current laser and how many operations have you performed on it? He had to think for a bit on this which is good because I don't think he has a prepared answer. "I have had this machine for three years and...*pause*... I've performed about 9000 operations on it." Whoa! That is...alot of operations. The man is good and efficient. 3000 operations per year averages to 57 or so patients a week. Conveyor belt much? He's a very nice doctor, but there's no way he can provide personal service to his patients if he lasers 57 eyes a week.
We then asked him about PRK (he recommends LASIK), and pupil size (my wife's pupil is on the bigger size but nothing to be concerned of). Eventually, we finished and he lead us to the case consultant or whatever her title is. Interestingly enough, they do offer a lifetime guarantee of some sort. The only thing is that it's only if your vision changes beyond -1D, 20/40 and precludes presbyobia. Hmmm...
Dr. Hyver seems like he's a very nice person. However, if we were to compare strictly technology, his technology is similar to Dr. Bindi's. However, his Ziemer femtosecond laser in my opinion is inferior to the iFS 150. His lifetime guarantee is nowhere as good as Bindi's. He does not provide a complete wavefront "custom" analysis or offer this custom procedure like Dr. Furlong's. The Allegretto is the laser of choice for the mass production of eyes. If you have low myopia then the Allegretto laser is not a bad choice. However, between Dr. Bindi and Dr. Hyver, the former appears to offer the better technology and better lifetime guarantee.
My husband and I are currently in the process of meeting with various doctors in the Bay area (just met with Dr. Bindi today) and weighing the pro's and con's as you are doing.
ReplyDeleteOur first appointment was at LaserVue Eye Center, Walnut Creek. The receptionist was rude to us and we did not get to see Dr Jay Bansal in person to answer any questions. An optometrist took our measurements and stated that we were both good candidates for Lasik after scanning our info over to the doctor. She had a hard time getting some of the equipment to work, which made me skeptical about the accuracy of the measurements taken.
Dr. Hyver’s office was much nicer and busy. It was reassuring to meet with him face to face, unlike at Dr. Bansal’s office. He recommended Lasik for my husband and PRK for me. This was interesting to hear because previously I had been told that I was a good candidate for Lasik. He was the only one that stressed waiting at least 3-6 months before getting pregnant after Lasik. Hormones during pregnancy can increase the incidence of haze occurring and this actually happened with one of his patients recently. Apparently she didn't realize she was pregnant at the time of the procedure. When I brought this up with Dr. Bindi he said this should not be a problem because the application of mytomycin C reduced the incidence of haze (of course being pregnant at the time is not recommended).
Dr. Bindi appeared approachable and answered all our questions. He also suggested that I get PRK instead of Lasik (2/3 docs told me I wasn’t a good Lasik candidate, with good reasoning which made me wonder, hmmmm….so are other patients of Dr. Bansal being told they are good candidates when they really aren’t?)
I started debating between Dr. Bindi and Dr. Hyver and was leaning towards Dr. Bindi because of the newer laser technology he uses but now I’m wondering if we should schedule a meeting with Dr. Furlong. I find all the testing tedious but we’ll see. Anyhow, your info is great and I’ll be following your blog as I’m interested to see whom you decide on going with!
Hi Bee,
ReplyDeleteI would be very wary and careful with doctors who do not have the time to see you personally. Did you know that Doctor Bansal and his wife were both on probation and temporarily lost their licenses for reusing microkeretome blades? Always check the California Medical board of your prospective doctors.
Here is doctor Bansal's license information: http://www2.mbc.ca.gov/LicenseLookupSystem/PhysicianSurgeon/Lookup.aspx?licenseType=G&licenseNumber=66178
Here is an article on LASIK and nursing: http://www.usaeyes.org/lasik/faq/lasik-pregnancy-pregnant.htm
If you don't mind my asking, what is your prescription for your eyes? Also, did you ask the doctors what the thickness of your eyes are? This will help you decide on PRK versus LASIK and whether the Allegro may make sense. I will also write a post, perhaps tomorrow on the potential of saving even more money if patients are willing to travel south to LA and San Diego.
I actually recommended PRK to my wife over LASIK. Unfortunately, she does not want to tolerate the pain and the down time. Having no flap is always better than having the flap. The flap may heal, but it will never be at the same strength as before. There has been cases of flap dislodging after years of LASIK.
I'm glad this blog is of some help. The information is out there. We should never make a decision on LASIK blindly (no pun intended).
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ReplyDeleteHi KD,
ReplyDeleteMy prescription is -1.75 in each eye and though I have thick enough corneas (don't remember the numbers), I was told by Dr Hyver and Dr Bindi that my corneas have an asymmetrical shape, which means PRK it is for me.
I hope that other people looking at Dr. Bansal are aware of his history. He has good reviews on Yelp and actually showed up as a USAeyes approved Lasik doctor (from the article on pregnancy you mentioned above) which seemed credible but you always have to dig deeper to make sure it seems.
I've heard of people flying down to LA for Lasik procedures but I always wondered if flying back for follow-ups makes the cost about the same?
Based on the studies, your eyes fall within the range where either wavefront technology would achieve good results. I wonder if asymmetrical shape is related to astigmatism. Do you happen to have high astigmatism by chance?
ReplyDeleteAs often happens in the medical field, different doctors have different interpretations based on the same data. The fact that two doctors agree and one disagree may tell you something. Then again, both opinions may be correct! The reason I'm saying this is that Dr. Bindi and Dr. Hyver both uses the Allegretto laser. Perhaps the custom wavefront technology is able to achieve good results with asymmetrical eyes? Dr. Bansal uses the VISX custom wavefront solution.
I would research more into this if I were you. Perhaps get another opinion, perhaps Dr. Furlong, Dr. Manche or another doctor who offers the custom wavefront-guided technology. If either of these doctors suggest PRK, then you would definitely know for sure.
As for USAeyes, did you know that the "approved doctors" have to pay for the right to be listed? Go to this section: http://www.usaeyes.org/certify/
Now go all the way down:
Term
Certification is renewed each calendar quarter. A certified doctor may end participation at any time. USAEyes will end certification if it is determined that the certified doctor no longer meets requirements. A surgeon may reapply for certification at any time after termination.
Fees
Primary Refractive Surgeon
$3,250 Initial Evaluation
$1,250 Quarterly Recertification Primary Surgeon ($5k/year total, includes website listing, annual re-survey, etc.)
No charges based upon patient referral, per impression, per click, or any similar quid pro quo.
This does sound like a paid advertisement to me.
There is another directory http://www.trustedlasiksurgeons.com/ but they lean heavily doctors in academia. Well qualified professors don't always have the best bed side manners. However, that's another resource for you.
Very useful post. This is my first time i visit here. I found so many interesting stuff in your blog especially its discussion. Really its great article. Keep it up. SurgeonGate
ReplyDeleteThanks for all the great info, I have just started looking into lasik. I recently came across lasikcomplications.com site and wondered if you are familiar with it. A lot of what they say really scares me and I am considering abandoning lasik, even just for the one eye. I'm curious whether you know of all the potential complications listed there and decided to go ahead anyway or if were you unaware of the many claims that they make, especially in regards to the understated percentages of issues. Thanks again for all the data you gathered and shared here.
ReplyDelete