LASIK gives way to alternatives; refractive surgeons more commonly undergo refractive surgery

ATLANTA — LASIK continued waning as lens-based refractive procedures gained ground in certain cases in 2008 while refractive surgeons and their families are more likely to undergo refractive surgery than the general population, according to a physician speaking here.

Richard Duffey, MD, gave results of the 2008 ISRS/AAO Member Survey during Subspecialty Day preceding the American Academy of Ophthalmology meeting.

Refractive surgeons and their families have undergone refractive surgery themselves at four times the rate of the general population, Dr. Duffey said.

"The take-home message is ... [there is a] 35% penetration among ourselves having refractive surgery on our own eyes and that's four times the general population and an even greater family index," he said. "Figure only about half of us are eligible, so that's a significant number."

For 10 D myopes, about half of members preferred phakic IOLs. For 3 D hyperopes, about two-thirds of members preferred LASIK but refractive lens exchange continued to gain. For 5 D hyperopes, two-thirds preferred refractive lens exchange over LASIK, Dr. Duffey said.

Results also showed 17% of members approve of bilateral phakic IOL implantation, up from 10% the previous year.

Surgeons preferred a flap thickness of 100 µm to 130 µm; 52% approved a minimum residual stromal bed of 250 µm and 47% preferred a residual stromal bed of more than 275 µm or more, Dr. Duffey said.

The thing that impressed me most was Dr. Duffey’s finding that the more people know about refractive surgery, the more likely they are to want to have it. The evidence behind that is his survey data showing that penetration of refractive surgery among refractive surgeons and their family members was four to five times greater than it is in the general population. Clearly, this is a procedure where the doctor is willing to take their own medicine. It’s a testament to just how powerful a procedure we have. The gap, the disconnect, is now going to be between what we know in this community and what we want the general population to know about the procedure. That should give a lot of motivation for surgeons who have had refractive surgery themselves to ask, “What do I need to do differently in my practice to better educate people out there so that they are as enthusiastic about this procedure as I am?”

– Shareef Mahdavi
President, SM2 Strategic, Pleasanton, Calif.