When you understand the massive costs involved to be able to perform this procedure, that is...
the prohibitive cost of the laser itself, paying royalty fees to the laser company each time you use the laser, paying for the facility in which the laser is located (rent and utilities) recalibrating the machine after each procedure ( costly ) paying your staff, incredible liability insurance, the cost of the vast amount of education and training that went into becoming
capable to perform this work, the necessary tools needed to aid in the procedure (micro-caratome for making flap in corneas aprox. $250,000.00)
(laser over $100.000,000.00) The costs are out of this world.

Sure would be nice to actually make a profit while your at it.

Laser centers all across the country are going belly up after one or two years. Interesting to note that they are centers that were charging the least.

Not a bad plan really; charge $500 to $600 per eye, don't pay your bills, don't keep up your insurance, higher cheap staff ( you know what you get for cheap don't you?) Don't calibrate your laser, default on your laser payments...By the time they repo the laser and your staff leaves, you have pocketed a tidy amount of money... now declare some sort of bankruptcy and go on vacation.

That is how you can do refractive surgery on the cheap. Pity those poor folks you worked on, and now no one want's to do their follow-up exams.

Hope this paints a clearer picture.