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LASIK still most common refractive surgical procedure
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CHICAGO — An annual survey indicates that LASIK is performed by about 90% of refractive surgeons, said Richard J. Duffey, MD, during Refractive Surgery Subspecialty Day here at the American Academy of Ophthalmology meeting.
After LASIK, the most common refractive surgical procedure is PRK, performed by 68% of respondents, followed by limbal relaxing incisions/IOL (57%), refractive lens exchange (39%) and limbal relaxing incisions alone (26%). Other refractive procedures were performed by less than 25% of respondents to the survey.
The survey was sent to the 2,000 members of the International Society of Refractive Surgeons; 246 responses were received, a response rate of 16.4%.
The survey asked respondents what their preferred surgical approach would be for several hypothetical refractive surgery candidates.
“For a 30-year-old, –10 D [patient], LASIK is preferred by 40% of surgeons, with phakic IOLs a close second, at 35%” Dr. Duffey said. “For a 45-year-old, +3 D [patient], LASIK is the preferred choice, but for a +5 D [patient], refractive lens exchange is the preferred method.”
The Bausch & Lomb Hansatome was the microkeratome preferred by the largest percentage (40%) of respondents, and 22% of respondents reported using the IntraLase FS femtosecond laser. The Visx Star S4 laser was preferred by 2 to 1 over other laser systems, Dr. Duffey said.
Among the IOLs now available for presbyopia correction, “the (Alcon) ReStor lens has already surpassed the (eyeonics) crystalens,” he said.
Monovision is still the most common mode for refractive surgical correction of presbyopia, preferred by 53%. Modified monovision was the second most preferred technique at 23%.
Almost three-quarters of respondents (72%) said they require a minimum central corneal pachymetry between 480 µm and 500 µm for performing LASIK.
An ambulatory surgery center was overwhelmingly the preferred site for implantation of phakic IOLs (78%), Dr. Duffey said.
Comanagement of refractive surgery patients has increased, from 40% of respondents in 2004 to 60% in 2005, he said.
Fewer than half of respondents (44%) reported seeing a documented case of post-LASIK ectasia in their own surgical patients over the course of their careers. Of the total respondents, 23% said they have seen only one case, 10% have seen two and 6% have seen three cases. No respondents reported seeing more than 10 cases of ectasia throughout their careers.
Results of this year’s survey will be available on www.duffeylaser.com, Dr. Duffey said.