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Practice styles and preferences of U.S. ASCRS members
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SAN DIEGO—Laser in situ keratomileusis procedures are declining in growth rates from 1997 through 2000, according to a survey of the American Society of Cataract and Refractive Surgery members, says David Leaming, MD. From 1997-1998, the growth rate for LASIK procedures was 158%, but declined to a growth rate of 30% in the 1999-2000 time frame. In that same time frame, the estimated annualized volume of LASIK procedures has increased from about 170,000 in 1997 to more than 930,000 procedures in 2000.
In a survey of the 5,342 ASCRS members, topical anesthetic use for cataract surgery was also on the rise, with 40% of respondents opting to use a topical anesthetic with intracameral lidocaine, followed by 24% who choose to use periocular anesthetics. Those figures increased from 37% opting for topical anesthetics in 1999 and a decrease from 27% of respondents who used periocular anesthetics in 1997.
In 1993, an overwhelming majority of respondents (about 75%) made their cataract incisions at 12 o'clock; in 2000, that number had dropped to 26%. Conversely, temporal incisions accounted for just 9% of all incisions in 1993; they now account for 55% of all incisions.
The four quadrant nucleofractis technique is still the most popular, with about 56% of respondents using that method in 2000. That figure has dropped from 1996's 70%. Clear corneal incisions are also on the rise, with only 1.2% using them in 1992. Today, 47% of respondents use clear corneal incisions.
Most surgeons see their patients three times for postop care, and 36% recommend corrective glasses for their patients about 4 weeks after the surgery.
The number of surgeons performing RK peaked in 1995, with 45% performing that procedure. On a steady decline since then, only 7% of surgeons performed RK in 2000.
Hyperopes in the +1 to +3 range are overwhelmingly recommended for LASIK surgery. At the +5 range, more than half the surgeons would recommend the patient wait before having any kind of surgery.
Most surgeons have plans to increase the amount of LASIK surgery they currently perform (60%). Of those surgeons not performing phakic IOL implantation, 70% plan on performing it in the future. More than half the surgeons do not currently perform LTK surgery, but plan on performing it in the future.
The top three types of courses surgeons have taken in 2000: RK, PRK and LASIK. More than half the respondents are not interested in training on the use of Intacs.
In 1999, 43% comanaged cataract patients, and 42% comanaged LASIK patients. In 2000, 42% comanaged cataract patients and 36% comanaged cataract patients.
The top three things members would change in their offices: add space (19%), improve personnel quality (10%) and improve efficiency, obtain better scheduling and electronic medical records (7% each).
For a detailed look at the survey, visit http://www.analeyz.com.