Patients often wonder why a procedure like LASIK, which hardly takes a few minutes, costs so much? Surely a doctor's time cannot be worth thousands of rupees a minute!!

The largest contributor to LASIK Costs are the capital costs. Lasers, like the excimer laser used in LASIK, can cost between 1.5 and 2 crore rupees (i.e. around USD 300000-400000). If you add a femtosecond laser, used to perform blade free lasik, the capital cost is more than doubled. A doctor needs to treat a lot of eyes to recover this kind of capital cost. This is especially true because every few years, typically five, technology improvements force eye surgeons or laser centers to invest in new machines. This means they must recover the entire capital cost, along with interest, within 5 years, only from patient fees.Interest costs in India are very high (around 12-15%), and this is coupled with customs tariff of around 10%, which further increases the capital cost and interest for Indian doctors. This is part of the reason for the high costs in India.

Consumable and license fees add another element of costs. Consumable costs for a lasik procedure typically include the cost of a set of disposable consumables, and also the excimer laser consumables and microkeratome blades.

An excimer laser used to perform LASIK is a gas based laser. It needs to be recharged every other day, even if the eye surgeon or laser center has performed only one case. It costs about Rs. 5000 (USD 100) for every recharge.

A microkeratome (used to make the LASIK Flap), needs a blade. Typically, manufacturers recommend that one blade (costing around Rs. 5000 or USD 100), be used only for two eyes of the same patient. Naturally, this adds significantly to the cost. Some eye surgeons or LASIK centers in India reduce costs by repeatedly reusing blades. This is not a particularly smart thing to do, especially from a patient point of view!!

License fees can be another contributor to costs. Some laser manufacturers (though not all). charge license fees for customized treatments, which cost around Rs. 3000 per eye (USD 60). All manufacturers charge a fee of around USD 150 (Rs. 7500) per eye for using the femtosecond laser. This adds significantly to the cost of blade free lasik.

So beware of the surgeon who charges you too little (the people who advertise prices of around Rs. 15000 per two eyes). Ask them some tough questions:

a) How old is your laser? Did you buy it new or refurbished?

b) When did you last upgrade your laser?

c) How often do you use microkeratome blades?

d) Will you operate me on any day I choose, or a specific date of your (i.e., the eye surgeon's) choosing?

All this has an impact on the costs of LASIK in India