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Long-term growth predicted in the refractive surgery market
New technologies plus a recovering economy are expected to boost refractive surgery again.
Although the refractive surgery market has been affected by the stagnant economy, new technologies allowing for safer and more precise vision correction will eventually overcome any economic downturns, said Gilbert H. Kliman, MD, MBA, managing director at InterWest Partners in Menlo Park, Calif.
The refractive surgery market has declined since its peak in 2000. In that year, 1.4 million people underwent LASIK. Last year, it dropped to just above 1 million. Despite the drop, the percentage of people wearing contact lenses is increasing, showing a growing market of those suited for the surgery.
Even though refractive surgery procedures have declined with the nation’s economy, there is still a large number of candidates. Increasing consumer confidence and surgeon investment in newer and safer technologies will help build up the specialty again, he said. He also recommends pricing that reflects the quality of the procedure.
Source: Taylor Consulting Group, MarketScope. |
“Invest in innovative surgical approaches, maintain premium pricing and cultivate your refractive practice,” Dr. Kliman said.
In a refractive surgery market analysis, Dr. Kliman determined that new technologies will spark a long-term growth trend. He expects improvements in technology over the next 5 years, including permanent solutions to currently untreatable refractive errors and presbyopia, he said.
“There’s a whole new approach evolving in refractive surgery,” Dr. Kliman told Ocular Surgery News. “Using wavefront correction as a standard of care for refractive surgery procedures is part of a bigger picture to make a safer and more accurate procedure.”
New technologies
As the market for refractive surgery has grown, so has the industry. New technologies such as wavefront-guided equipment and IntraLase, a femtosecond laser, are beginning to change refractive surgery standards, Dr. Kliman said.
“The challenge to surgeons is that the equipment is getting more expensive because the procedure is getting better. With the newer technologies, there is an additional expense but also a significant benefit to the surgeon and the patient,” he said.
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LASIK using wavefront and IntraLase technologies may have greater predictability of visual outcome, and has become safer since radial keratotomy (RK) and photorefractive keratectomy (PRK) entered the market in 1980 and 1990, he said. Wavefront uses higher-order aberrations to correct refractive errors, and IntraLase uses a short-pulse laser to cut corneal flaps, replacing the microkeratome.
Despite the advances, surgeons have had an inconsistent focus on how they have approached the market and consumer confidence has waned, Dr. Kliman said.
Patient perception
Although the potential refractive surgery market has grown, weak consumer confidence coupled with a declining economy have been the major factors affecting LASIK surgery volume, Dr. Kliman said. According to the market analysis, patients view LASIK as a good procedure, but one that still has complications.
“It’s not clear that the complication rate has changed; if anything, it’s just that there are a lot more people getting the surgery, so there’s a larger absolute number of reported complications. What everybody wants is to make the complication rate zero. That’s why there is interest and a required investment in these new technologies that will decrease the complication rate and give a better visual outcome,” Dr. Kliman said.
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Surgeon focus
The successful refractive practice requires commitment with people, time and money, Dr. Kliman said. Low pricing and inadequate patient education about the procedure have inadvertently kept a significant portion of surgery candidates from electing the procedure.
“Focus on patient experience and outcomes. Cutting price does not increase the market size,” he said.
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A 3-year analysis of LASIK pricing showed that pricing declined by $1,000 from 1997 to 2000, he said. He said consumers view cost as a reflection of how the surgeon values the procedure.
“Real discount pricing — $499 per eye — is one of the most negative things about refractive surgery because it degrades the perceived quality of the procedure. People who go for that are not focusing on quality. It seems like the most important thing in LASIK is quality,” Dr. Kliman said.
Other market studies have shown that patients are willing to pay more for a safer and more effective procedure. Such a perception makes investment in new technology more feasible.
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Invest now
Dr. Kliman advised that surgeons should continue searching for technologies that decrease the complication rate and increase vision outcome. In choosing a new technology to invest in, look at the cost of the equipment and the cost per procedure, he said.
“Look not only at cost but also what value you get out of it. Look at capital equipment cost vs. the cost per procedure because you need to look at the whole picture,” he said.
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He compared a surgeon’s investment plan to that of personal investment, where there are high and low risks. Refractive surgery is considered a high-risk investment because it can fluctuate with the general economy or market perceptions. Investing in it is necessary in order to increase a refractive surgery practice, and is worth it because of the very high returns, he said.
“Even though it looks risky to be involved in refractive surgery now because of the low volume, effects of the economy and perceived complications, investing is an important part of ophthalmology. In growing your practice through investment in new technologies, you’re also going to give the best outcome,” Dr. Kliman said.
For Your Information:
- Gilbert H. Kliman, MD, MBA, can be reached at InterWest Partners, 2710 Sand Hill Rd., Second Floor, Menlo Park, CA 94025; (650) 854-8585; fax: (650) 854-4706; e-mail: gkliman@interwest.com; Web site: www.interwest.com. Dr. Kliman has a direct financial interest in the IntraLase femtosecond laser.