A system and method for providing a predictive outcome in the form of a predictive best instruction for a therapeutic ophthalmic correction of a patient's vision defects. The predictive best instruction is derived from prospective therapeutic-outcome-influencing, new information that is analyzed in conjunction with optimized, historical therapeutic-outcome information. The instruction is preferably an optimized, custom, photoablative algorithm for driving a photoablative, excimer laser. The instruction can be provided on a fee basis.