US Trends in Refractive Surgery: 2007 ASCRS Survey

Richard J. Duffey, MDRichard J. Duffey, MDDavid Leaming, MDDavid Leaming, MD

Chicago: April 8, 2008Chicago: April 8, 2008

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Disclosures

The authors actually spend some of their The authors actually spend some of their own hard-earned dollars to cover the annual own hard-earned dollars to cover the annual printing and analyzing costs of this survey.printing and analyzing costs of this survey.

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Lou Holtz “Rule of Tens”

Fewer than 10% of you will remember Fewer than 10% of you will remember more than 10% of what I said more than 10 more than 10% of what I said more than 10 minutes after I said it.minutes after I said it.

So, look for the *So, look for the *

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2007 ASCRS Survey Sept. mailing to 4797 U.S. members of ASCRSSept. mailing to 4797 U.S. members of ASCRS 628 responses representing 13% of the U.S. ASCRS 628 responses representing 13% of the U.S. ASCRS

membershipmembership Eleventh year of refractive data collection allowing Eleventh year of refractive data collection allowing

analysis and comparison of trends amongst ASCRS U.S. analysis and comparison of trends amongst ASCRS U.S. surgeons surgeons

Alphabet soup of refractive surgery.Alphabet soup of refractive surgery. Added questions in recent years as the field has Added questions in recent years as the field has

incorporated new laser and refractive technologies incorporated new laser and refractive technologies including premium IOL’s.including premium IOL’s.

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Preferred Surgery for 30 yo -10.00 Diopter Myope

*

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Preferred Surgery for 45 yo +3.00 D Hyperope

*

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Preferred Surgery for 45 yo +5.00 D Hyperope

*

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Currently are a Refractive Surgeon and have had Refractive Surgery Performed on Yourself

*Greater than 4times the pene-tration comparedto general public

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Surgeon Willing to do Bilateral Surgery at the Same Visit

*

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Microkeratome Used Most

25%*

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Epi-Keratome Use

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Excimer Used Most

*

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Wavefront-Guided Custom Ablations in Your Practice

*

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Preferred Surgery for Presbyopia

*Multifocal IOLs 36%

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Do You Intra-operatively Measure Flap Thickness?

*

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Preferred Flap Thickness (when no other constraints)

*

*

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Minimum Residual Stromal Bed Thickness Requirement

*

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Total Cases of Post LASIK Ectasia as the Primary Surgeon in Career

*the numbers are not growing

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Minimum Preop Corneal Pachymetry for LASIK (all other parameters normal)

*

*

*

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Mitomycin-C Use (MMC)

*

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Will You Perform Refractive Surgery on One-Eyed Patients

*

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When Co-managed, Who Sees Postop LASIK Patient on Day 1 ?

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Minimum “OR” Location for Phakic-IOL Surgery

*

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Refractive Surgery Volumes (extrapolated data in thousands)

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2007 ASCRS SUMMARY

Volume of LVC (U.S.) in 2007: Volume of LVC (U.S.) in 2007: 1.08 M eyes1.08 M eyes (1.12 M in ’06). 10 M since 1996.(1.12 M in ’06). 10 M since 1996.

P-IOLP-IOL (36%)(36%) and LASIK (23%) in high myopes. and LASIK (23%) in high myopes. VisXVisX still at > 3:1 ( still at > 3:1 (72%)72%) over all other lasers over all other lasers Greater than 30% penetrationGreater than 30% penetration of modern of modern

refractive surgery amongst refractive surgeons.refractive surgery amongst refractive surgeons. 84%84% (still rising) use MMC for prophylaxis / (still rising) use MMC for prophylaxis /

haze.haze.

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2007 ASCRS SUMMARY

Most desired flap thickness is 120-130 microns. 100 Most desired flap thickness is 120-130 microns. 100 micron flap thickness is favored by micron flap thickness is favored by 20%20% of surgeons (up of surgeons (up from 11% two years ago).from 11% two years ago).

Only 1%Only 1% of respondents are OK with of respondents are OK with bilateralbilateral P-IOL P-IOL (11% last year) and 4% with RLE at the same surgical (11% last year) and 4% with RLE at the same surgical setting.setting.

ReStor ReStor (18%),(18%), ReZoom (10%) and accommodative IOLs ReZoom (10%) and accommodative IOLs (8%) are gaining popularity as lens-based presbyopia (8%) are gaining popularity as lens-based presbyopia options.options.

Thanks to ASCRS leadership for their support and for your

participation in the 2007 Survey

We look forward to your responses in We look forward to your responses in the 2008 survey this autumn.the 2008 survey this autumn.

Complete results this Friday at Complete results this Friday at www.duffeylaser.comwww.duffeylaser.com