Are You a Good LASIK Candidate?

The best way to determine if you are a good LASIK candidate is to schedule a consultation with a trusted physician. But even a good surgeon does not know you inside and out. Here are some good guidelines from the FDA at determining your LASIK candidacy.

You are probably NOT a good candidate for refractive surgery if:

• You are not a risk taker. Certain complications are unavoidable in a percentage of patients, and there are no long-term data available for current procedures.
  It will jeopardize your career. Some jobs prohibit certain refractive procedures. Be sure to check with your employer/professional society/military service before undergoing any procedure.
• Cost is an issue. Most medical insurance will not pay for refractive surgery. Although the cost is coming down, it is still significant.
• You required a change in your contact lens or glasses prescription in the past year. This is called refractive instability. Patients who are: In their early 20s or younger,
  Whose hormones are fluctuating due to disease such as diabetes, Who are pregnant or breastfeeding, or Who are taking medications that may cause fluctuations in vision, are more likely to have refractive instability and should discuss the possible additional risks with their doctor.
• You have a disease or are on medications that may affect wound healing. Certain conditions, such as autoimmune diseases (e.g., lupus, rheumatoid arthritis), immunodeficiency states (e.g., HIV) and diabetes, and some medications (e.g., retinoic acid and steroids) may prevent proper healing after a refractive procedure.
• You actively participate in contact sports. You participate in boxing, wrestling, martial arts or other activities in which blows to the face and eyes are a normal occurrence.
• You are not an adult. Currently, no lasers are approved for LASIK on persons under the age of 18.

Precautions:

The safety and effectiveness of refractive procedures has not been determined in patients with some diseases. Discuss with your doctor if you have a history of any of the following:

• Herpes simplex or Herpes zoster (shingles) involving the eye area.
• Glaucoma, glaucoma suspect, or ocular hypertension.
• Eye diseases, such as uveitis/iritis (inflammations of the eye)
• Eye injuries or previous eye surgeries.
• Keratoconus

Other Risk Factors

Your doctor should screen you for the following conditions or indicators of risk:

• Blepharitis. Inflammation of the eyelids with crusting of the eyelashes, that may increase the risk of infection or inflammation of the cornea after LASIK.
• Large pupils. Make sure this evaluation is done in a dark room. Although anyone may have large pupils, younger patients and patients on certain medications may be particularly prone to having large pupils under dim lighting conditions. This can cause symptoms such as glare, halos, starbursts, and ghost images (double vision) after surgery. In some patients these symptoms may be debilitating. For example, a patient may no longer be able to drive a car at night or in certain weather conditions, such as fog.
• Thin Corneas. The cornea is the thin clear covering of the eye that is over the iris, the colored part of the eye. Most refractive procedures change the eye’s focusing power by reshaping the cornea (for example, by removing tissue). Performing a refractive procedure on a cornea that is too thin may result in blinding complications.
• Previous refractive surgery (e.g., RK, PRK, LASIK). Additional refractive surgery may not be recommended. The decision to have additional refractive surgery must be made in consultation with your doctor after careful consideration of your unique situation.
  Dry Eyes. LASIK surgery tends to aggravate this condition.

Diabetes and Vision

Diabetes has serious effects on eye health, and rates of the disease are rising rapidly around the globe - in 2007 approximately 246 million people worldwide had the disease, and the International Diabetes Foundation estimates that number will jumpt to 324 million by 2025.

To make matters worse, there is a disturbing lack of awareness of the impact diabetes has on eye health and vision: In Transistions Optical's second annual Healthy Sight Survey, between one-third and two-thirds of respondents didn't identify vision problems as a side effect of diabetes.

Ocular Effects

Diabetes can lead to the development of eye diseases, including cataracts, diabetic retinopathy, age-related macular degeneration (AMD), and glaucoma.

Diabetic retinopathy may also lead to retinal cell phototoxicity, which is an extreme adverse reaction to UV light. In the U.S., 40.3 percent of diabetics over age 40 have diabetic retinopathy, and 8.2 percent have vision-threatening retinopathy.

In addition, diabetic retinopathy and cataracts have been associated with reduced contrast sensitivity and also increased susceptibility to glare.

If you are diabetic, it is crucial to have frequent dilated eye exams to monitor and prevent vision loss. If you have sudden vision changes, contact your eye care provider.

Are You Protecting Your Eyes?

A new survey conducted by the New England Eye Institute (Boston) and Transitions Optical (Pinellas Park, Fla.) has found that only 5% of consumers are aware that ultraviolet (UV) exposure can cause damage to their eyes, the two organizations reported jointly in a press release. The study also found that more than half (57%) of respondents said they do not wear protective eyewear when in the sun for extended periods. Those surveyed said they spend about 3.5 hours outdoors daily, which represents an average of 1,000 of unprotected UV exposure per year. A total of 80% of respondents were aware of the risk of skin cancer associated with UV exposure, the organizations said.

In an earlier post (Beyond Fashion, Why You Gotta Wear Shades) we gave more information regarding UV protection. Sun damage is serious and preventable. There is no such thing as overprotecting your eyes!

What the heck is monovision?

You may have heard the term monovision in your LASIK research. Monovision is a type of correction made in patients who need glasses for distance and, because of aging eyes, also need glasses for up close vision. Instead of correcting both eyes for distance vision, one eye is corrected to see far and the other is left slightly uncorrected in order to see up close. Sounds like a headache? Actually, its not. Once your brain adjusts to it, you can't tell that only one eye is getting you the clear picture. Both eyes seems to be giving you both distance and near vision.

LASIK monovision is a viable and increasingly accepted method for correcting presbyopic (near vision lost due to aging) and pre-presbyopic refractive surgery candidates, according to results from a recent study. In addition, crossed monovision, in which the dominant eye is corrected for near vision, may be applied successfully in suitable candidates.

“Although the overall success of monovision was good, patient selection is extremely important, as not every patient can adapt to monovision,” the study authors said. “Patients selecting monovision should also be aware that the reliance on one eye for distance vision makes an enhancement procedure more likely than if bilateral distance vision is chosen.”

Roger F. Steinert, MD, and colleagues retrospectively analyzed the preoperative characteristics and postoperative outcomes of 284 patients 45 years or older who elected to undergo LASIK to correct myopia or hyperopia. Subsequently, refractive success, functional success and patient enhancement rates were evaluated for patients treated with monovision correction. Of 284 total LASIK patients, 188 (67%) elected to undergo monovision correction and 96 (34%) chose bilateral distance correction.

Dr Drucker recommends Monovision if one can get adjusted. The only way to determine this before lasik is a trial with lenses prior to LASIK. Many of our patients elect to have monovision knowing that if they are not happy with it and do not accomodate they can have a retreat that will correct both eyes to see distance and then reading glasses can be used for near. People with certain personalities, occupations and lifestyles are better candidates than others. If you see ads for “getting rid of reading glasses”, monovision is what it’s all about. Dr. Drucker has monovision himself! (Dr. Drucker has one eye corrected for distance and the other for intermediate or computer distance. He wears his glasses for very close vision.)

PRK: The original laser eye surgery

It may be hard to believe these days, when everything is "LASIK this" and "LASIK that," but PRK (photorefractive keratectomy) used to be the most common refractive surgery procedure.

Both are grouped under the umbrella "laser eye surgery," but each is a little different when it comes to advantages and disadvantages.

LASIK patients have less discomfort and obtain good vision more quickly (with PRK improvement is gradual and over a few days or even months), but many surgeons prefer PRK for patients with larger pupils or thin corneas. Dr. Drucker is one of these surgeons, and, in fact, is a PRK specialist.

PRK was invented in the early 1980s. The first FDA approval of a laser for PRK was in 1995, but the procedure was practiced in other countries for years. In fact, many Americans had the surgery done in Canada before it was available in the United States.

PRK is performed with an excimer laser, which uses a cool ultraviolet light beam to precisely remove ("ablate") very tiny bits of tissue from the surface of the cornea in order to reshape it. When you reshape the cornea in the right way, it works better to focus light into the eye and onto the retina, providing clearer vision than before.

Both nearsighted and farsighted people can benefit from PRK. With nearsighted people, the goal is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. Also, excimer lasers can correct astigmatism by smoothing an irregular cornea into a more normal shape.

IF YOU HAVE BEEN TOLD YOU WERE NOT A CANDIDATE FOR LASIK, YOU MAY WANT TO SEE IF YOU ARE A CANDIDATE FOR PRK. CHECK BACK NEXT WEEK FOR MORE ON THE PRK PROCEDURE.

Beyond Fashion: Why You Gotta Wear Shades

Cheap sunglasses may cost you less, but are they just as likely to protect against the effects of harmful UV rays as expensive sunglasses?

According to Dr. Donald J. D'Amico, chair of ophthalmology at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, there is no certain way for consumers to be sure they are getting ultraviolet or UV protection from their sunglasses -- even if they are labeled "UV absorbing" or "UV blocking." Cost is no indicator of UV protection. An expensive pair of sunglasses does not guarantee sufficient protection from the sun.

"There is no government regulating power for the classification of sunglasses," says Dr. D'Amico. As a result, company information may misrepresent how much protection their sunglasses offer; and, unfortunately, consumers sometimes assume all sunglasses have protection if they are dark in color.

Dr. Stephen Trokel, an ophthalmologist at NewYork-Presbyterian Hospital/Columbia University Medical Center, advises that consumers buy sunglasses from reputable companies to ensure that they block both UVA and UVB rays. Another tip is to pair sunglasses with a large-brimmed hat to protect the eyes from sunlight that may enter from above and from the sides of glasses. Wraparound sunglasses and those with large temples also provide important side protection.

Sunglasses are not just a fashion statement; their lenses block harmful UV rays that, in severe cases, can cause permanent damage to the eyes in the form of cataracts, pterygium and possibly retinal degeneration.

Dr. D'Amico and Dr. Trokel caution that consumers should be aware of the following:

- Persons with light-colored eyes, such as blue and green, are often more sensitive to bright sunlight than darker eye shades.
- Individuals who wear contact lenses are least likely to want to wear sunglasses; however, sunglasses are helpful from preventing the drying effect most contact lens wearers get from warm wind; UV protection in contact lenses are the most effective in blocking all UV entering the eye.
- While not always true, the darkness of sunglasses will indicate greater UV protection -- at least if they comply with the ANSI Z80.3 industry standard.
- Automobile window tints are not a replacement for sunglasses; however, windshields screen out and are very effective in absorbing both UVA and UVB rays (because of the internal shatter-proof laminate).

In addition, Dr. D'Amico and Dr. Trokel emphasize that you are never too young to protect your eyes from the sun's harmful rays. Parents should purchase UV-protected sunglasses for their children with wraparound design and keep infants' eyes shaded.

David Drucker Becomes First Ever "Honorary" Lion's Club Member

David Drucker, MD, PC was honored Tuesday as the first ever "Honorary Member" of Denver's Chapter of the Lion's Club for his work and contributions to the Lion's Club Eye Exams for the Needy Program. Our office has provided eye exams for the homeless and destitute through the Lion's Club for the past five years. The Lion's Club has taken the results of these exams and made glasses for these patients. This contribution has helped many needy people receive the glasses that allow them to function on a daily basis. Many of these patients are then able to find work and make a better life for themselves with their sight restored.

Along with providing exams for the Lion's Club, our office has also performed eye exams for the Stout Street Clinic. The Stout Street Clinic is a local organization that helps recovering alcoholics and drug addicts. Many of their members are also homeless and jobless and are very grateful for the services we provide at no charge to them.

Congratulations to Dr.David Drucker for being recognized for his contribution to this group of underserved Colorado residents.

Do You Suffer From Excessive Underarm Sweating?

Summer and hot weather are welcomed by most, but if you suffer from excessive underarm sweating, you may be dreading the coming months. However, if underarm sweating is significantly interfering with your daily activities and topical agents haven't worked, you may be a candidate for BOTOX® treatment. First, it's important to understand the condition.

Excessive underarm sweating is a medical condition known as primary axillary hyperhidrosis which involves overactive sweat glands. Sweat is your body's temperature regulator. In primary axillary hyperhidrosis, sweating significantly exceeds the body's normal requirements for cooling.

For more information about excessive underarm sweating, visit the International Hyperhidrosis Society Web site at http://www.sweathelp.org/.

A number of different treatments and products are available to help people with excessive underarm sweating including special deodorants, surgery and BOTOX® treatments. BOTOX® is FDA-approved for excessive underarm sweating that is inadequately managed with topical agents. BOTOX® helps control this condition by temporarily blocking the chemical signals from the nerves that stimulate the sweat glands. When the sweat glands don't receive chemical signals, the excessive sweating stops.

After a BOTOX® treatment, you should notice a significant reduction in underarm sweating within 4 weeks. There is a possibility that some sweat glands may be missed, and you may continue to experience some sweating from the untreated areas. If you do not see a significant reduction in sweating, you should contact your healthcare provider and request a follow-up consultation.

And how does sweating fit into an eye health blog? Introduced over thirty years ago, ophthalmologists were the first to use BOTOX®, treating crossed eyes and eyelid spasms. Today BOTOX® has become FDA approved for many treatments from wrinkle reduction to migraine relief. If you suffer from excessive sweating, ask your ophthalmologist or dermatologist if BOTOX® might be right for you.

David Drucker, MD currently treats excessive underarm sweating with BOTOX®. The procedure is in office and there is no down time. Call today for a free consultation: (303) 293-9311.

LASIK and the FDA

Last week, you may have heard LASIK news such as the following:

"The FDA’s Ophthalmic Devices Panel heard last Friday from both satisfied and dissatisfied LASIK patients, as well as representatives from the American Academy of Ophthalmology and the International Society of Refractive Surgery (ISRS) of the American Academy of Ophthalmology who spoke about the extensive track record of safety and effectiveness for LASIK.

Following a long day of testimony and presentations, the panel made several recommendations for consideration by the FDA, including:

• Adding photographic illustrations of certain side effects to the FDA Web site
• Better explanation of certain outcomes, such as myopic patients who have LASIK eventually needing reading glasses post surgery
• More understandable information about the potential risks of LASIK (such as dry eye, halos, glare, starbursts, etc.) and about conditions that might make a patient a poor candidate for LASIK (such as a family history of keratoconus and a history of depression)
• Additional information or guidance in the labeling about postoperative intraocular pressure, and additional guidance for implant measurement for post LASIK cataract surgery"

Yeah, you say, but what does that mean?

It means that LASIK is as safe as it has always been. But LASIK, no matter how simple and quick the results are, is still a surgery. With any surgery, there are risks and chances of complications. Unfortunately there are doctors who perhaps do not emphasize these risks well enough to their patients and there are patients who, even though informed, do not pay enough attention to these risks. As a result, patients are undergoing LASIK surgery without being fully informed.

The panel of advisors for the FDA that met last week has put together a list of suggestions hoping to better educate patients before they undergo surgery. As an office that provides LASIK, we are proud to say that we already adhere to these recommendations. As a patient seeking LASIK, our advice to you is to learn all you can before you undergo the vision correction procedure. Learn your options and be honest about your eye history. If you suffer from dry eye, perhaps you should consider PRK instead. If you have a family history of kerataconus, ask your doctor if LASIK is really right for you.

LASIK surgery is an extremely beneficial procedure. Millions of people around the world have undergone the procedure and are happy with their results. Whether or not you would be happy with LASIK depends a lot on your expectations. Research, ask questions, and think carefully before getting your eyes zapped. Your comfort with your doctor and the information you receive will greatly determine your comfort post-procedure.

Reasons for Having Eye Surgery

VisionWatch, a large-scale, continuous consumer-based measurement of the U.S. eyewear market, surveys 100,000 consumers annually about their attitudes, awareness, behaviors and purchasing patterns in all areas of the eye care industry. Recently they surveyed patient who had laser vision correction asking, "What events prompted you to have eye surgery?" The primary reason was due to consumers feeling glasses or contacts were an increasing hassle. Almost a third just decided it was time to have it, while a quarter did it because friends or family had it done.

Here's the results in detail:

What events prompted you to have eye surgery?

• Friends/family had it done.....26.3%


• The expenses were reimbursed or partially reimbursed by insurance.....17.0%


• Pretax medical benefits provided some relief of cost.....7.0%


• Glasses or contacts became increasing hassle.....44.6%


• Financing terms available by the doctor's practice made it affordable.....12.3%


• New technology that offers more precise correction.....20.9%


• Just decided it was time to have it.....33.0%


• Don't know/can't remember.....4.0%

Do You Know About Velashape?

The evolution of cellulite treatment has taken another leap forward with the introduction of VelaShape. Syneron's new VelaShape can be used predictably for quickly losing inches, which makes it attractive for those patients who desire faster results.

Syneron, the maker of VelaShape, is already known as a leader in the development of cellulite reduction technology due to the success of VelaSmooth. Velashape is a combination of Bi-Polar Radio Frequency and Infrared Light delivered through tissue mobilization combined with suction, to reduce the appearance of cellulite and re-contour problem areas.

One great use of Velashape: Body After Baby. Weight gain during pregnancy is healthy and natural, but many women crave to return to their pre-pregnancy bodies after childbirth. Alongwith a balanced diet and exercise, VelaShape’s revolutionary technology can help achieve body contouring through Circumferential Reduction.

Dr. Drucker has been offering Velashape since January of this year and our patients have been ecstatic with the results. Rachel Ray and Dr. Phil have both featured Velashape on their shows recently so you may have seen results. Visit our website to see our Rachel Ray clip or call us to set up a free consultation to see if Velashape is right for you.

LASIK Lifetime Guarantee: Too Good To Be True

I'm sure you've seen the LASIK ads promising "20/20 or free" or "lifetime commitment". These offers sound amazing, the obvious way to go, but they do have limitations, and also some surprises.

Outcome Can Not Be Guaranteed
No matter how good your surgeon is, no one can guarantee what your results will be. How well you see after LASIK can be very different than expected, or it can be exactly what the doctor predicted. LASIK centers that offer a financial commitment to a certain outcome are simply gambling. Odds are in favor of most patients having a great result. Surgeons that bet on that are merely willing to pay out the few times the outcome is not ideal in order to get business in the first place. And if you don't have an ideal LASIK result, will giving you a refund really be the response you want from your surgeon?

Guarentees Cost More
Most clinics that offer these money back guarantees in their ads don't mention that you have to pay more. I've seen clinics charge as much as $1000 more per eye for "Worry Free LASIK". Does this mean your surgeon only promises good results if you pay more?

What is the definition of LASIK success?
The Snellen 20/20 chart is a valuable measurement system, but it is not the only consideration for quality of vision. A patient may see 20/20 yet have debilitating halos at night, for example. Perhaps you see 20/20 but are still not happy with your results. Does this mean that your procedure was a success?

Who's lifetime?
While it may be admirable for a clinic to want to provide this level of care to its patients, the reality is that what constitutes a lifetime may be a matter of contention. What happens if the doctor dies? What happens if the company for which the doctor worked goes bankrupt? What happens if the publicly held corporation by whom the doctor was employed is merged into another company that does not have a "lifetime commitment" program? What if the doctor didn't have a "lifetime commitment" program, but then started working for a company that does? What if the patient moves out of the area?

When Dr. Drucker began performing LASIK, he peformed his surgeries at Clear Vision Laser Centers which offered lifetime "free retreats". Eventually, TLC bought out Clear Vision and TLC did not offer the lifetime "free retreats". Though Dr. Drucker still honored his commitment to free retreats, the laser center now requires a facility fee after 2 years. Very few patients have returned for retreats after 2 years (most needed retreatments can be determined within 2 years), but a few patients have had to pay this facility fee directly to TLC. Though these patients paid for a lifetime of free retreats, they no have no legal recourse since their contract was with Clear Vision iand they are no longer in business.

New Technology & Techniques
And then there is the issue of what is included in the "commitment"? Does this mean that no matter what new technology or technique comes along the patient will receive this for free for as long as the patient (and the doctor/clinic/corporation) lives? It is reasonable to assume that advancements will make whatever the patient had seem obsolete. One can hardly expect a medical procedure to be exactly the same after 10-20-30 years. Does the patient get the new procedure for free? Most clinics will charge an "upgrade" fee. For instance, patients who had Traditional LASIK 5 years ago who now want a retreat will often be offered Intralase to receive the optimum results but they will be charged for the technology upgrade.

These are just a few of the issues related to LASIK Lifetime Warranties. The bottom line is that patients need to be aware. Each patient is unique and individual. Your surgeon should be willing to give you personalized care and treatment whatever your results. If you are unhappy with your LASIK outcome, the ideal surgeon will listen to your concerns and address them, trying his or her best to correct them. This kind of service should be expected without a financial commitment.

More Than 95 Percent Satisfaction Rate Worldwide Reported By LASIK Patients

Worldwide, an average 95.4 percent of LASIK patients are satisfied with their new vision, according to the first review of the world body of scientific literature, the American Society of Cataract and Refractive Surgery (ASCRS).

With 16.3 million patients having had LASIK worldwide, and more than a decade of clinical study and technological innovation behind it, LASIK is considered among the most successful elective procedures available today.

"We find that there is solid evidence in the world's scientific literature to affirm that there is an exceptionally high level of satisfaction in patients who have had LASIK surgery. While no surgery is perfect, certainly the 19 peer-reviewed studies of 2,199 patients show extremely high satisfaction rates," said Richard L. Lindstrom, M.D., president of the ASCRS. "While patient satisfaction is extremely high, we recognize that there are patients who have unsatisfactory outcomes. As surgeons, we have taken the Hippocratic Oath. The well being of all of our patients is central to what we do and what we are. As such, and as the history of medicine has shown, we are committed to advancing our technology, patient selection, and surgical techniques so that we can continue to enhance the quality of our patient's lives," Lindstrom added.

The meta-analysis, led by Kerry Solomon, M.D. at the Storm Eye Institute of the Medical Center of South Carolina, examines nearly 3,000 peer-reviewed articles published over the past 10 years in clinical journals from North America, South America, Europe, Asia, Africa and Australia. The research employed the Ovid and PubMed data bases using the term "LASIK" and similar search terms. A total of 2,915 articles were identified. "We wanted every article we could find, up to and including our last search, which was done on January 8, 2008," Dr. Solomon said.

"This survey goes back to literature published 10 years ago. In that time, there have been major technological advances, such as wavefront-guided LASIK and the introduction of special lasers to form a flap on the surface of the eye in preparation for the laser treatment. Coupled with better surgical techniques, and improved patient selection, we can say that modern LASIK is a mature procedure. It is important to note that its reliability and effectiveness have led to its adoption by the armed forces, in particular the US Navy, and the National Aeronautics and Space Administration for improving the vision of its front-line pilots and astronauts," Dr. Solomon said.

Key Findings from "LASIK: A Global Perspective on Patient Satisfaction"

* 95.4 percent of LASIK patients worldwide report satisfaction with the outcome of their procedure.
* Approximately the same percentage would recommend LASIK to a friend or would elect to undergo the procedure again.
* More than 95.2 percent of LASIK patients in the U.S. are satisfied with the outcome of their procedure.
* Outside the U.S., studies from France, India, Iran, Ireland, The Netherlands, Scotland, South Africa, Spain, Turkey, United Arab Emirates, and The United Kingdom, report very similar patient satisfaction rates of about 95.6 percent.
* The total range of satisfaction rates in individual studies was from 87.2 percent to 100 percent.

The first goal of the literature review is to assist in quantifying and qualifying aspects of LASIK patient satisfaction for a joint task force formed by the U.S. Food and Drug Administration (FDA) and including the ASCRS, the American Academy of Ophthalmology (AAO), National Eye Institute (NEI), and other members of the health community. "

Not everyone is a good candidate for LASIK. As ophthalmologists, historically the determining factor for candidacy has been the health of the eye and the refractive correction," said Dr. Solomon. "Along with continued technology advances, exploring a more holistic approach to patient screening, with considerations for both physical and psychodynamic factors, may be the answer to further increasing patient satisfaction."

"Once a technology matures to this point, a profession committed to continual improvement will naturally focus on improving patient satisfaction," said Dr. Lindstrom. "As the number-one elective procedure in the world, with one of the highest safety profiles, LASIK has shown its appeal to patients, and, as a profession, we look forward to continuing its advancement."

There has never been a better time to have laser vision correction. Call us today to schedule a free consultation!

Another Reason to Choose Dr. Drucker

Have you heard about our latest services? We now offer State-Of-The-Art Cosmetic Laser Services including wrinkle reduction, skin tightening, skin rejuvenation, acne treatments, cellulite reduction (as seen on Rachel Ray) and laser hair removal. We have very competitive prices and excellent service. For the month of March, we are featuring 30% off any treatment or package!

"People always want to change how they see and how they look," Dr. Drucker says. "I've spent years helping people see better. Helping people look better is just the finishing touch."

As an added benefit to our LASIK/PRK patients, we give One Free Cosmetic Treatment. They also receive a 20% lifetime discount on Cosmetic Packages. Just another reason to choose Dr. Drucker for LASIK or PRK!