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ISRS survey: LASIK volume continues decade-long decline
The percentage of surgeons performing at least 75 LASIK cases per month dropped from 27% in 2001 to 9% in 2012.
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CHICAGO — The percentage of surgeons performing at least 75 LASIK procedures per month has declined steadily since 2001, according to the results of an annual survey.
Richard J. Duffey, MD, OSN Refractive Surgery Board Member, presented results of the U.S. Trends in Refractive Surgery: 2012 International Society of Refractive Surgery Survey during Refractive Subspecialty Day preceding the joint meeting of the American Academy of Ophthalmology and Asia-Pacific Academy of Ophthalmology.
The 16th survey was the fourth conducted online; 376 of 1,150 ISRS members opened the email survey and 127 responded, Duffey said. Only U.S. members were surveyed.
Results showed that 9% of respondents performed more than 75 LASIK procedures a month; the percentage was the same as in the 2011 survey.
“We arbitrarily decided 15 or 16 years ago that 75 cases per month was high volume,” Duffey said. “For LASIK procedures, that has dropped from 27% at that volume down to 9% over the last 11 or 12 years. We peaked in 2001, and [the percentage] continues to decline in the U.S.”
Refractive surgery
Survey results showed that 86% of respondents performed LASIK and 88% performed surface ablation; 79% implanted toric IOLs and 71% implanted presbyopic IOLs. Toric and presbyopic IOLs were included in the survey for the first time, Duffey said.
“Seventy percent to 80% of us are doing the premium IOL procedures,” he said.
For a 30-year-old 10 D myope, 28% of respondents preferred LASIK, 17% preferred surface ablation, and 41% preferred phakic IOLs.
“Most of us are still going to do laser vision correction,” Duffey said.
For a 45-year-old 3 D hyperope, 60% of respondents preferred LASIK, 10% preferred surface ablation, and 20% preferred refractive lens exchange.
The preferred treatment for a 45-year-old 5 D hyperope was refractive lens exchange among 62% of respondents and LASIK among 9%; 19% of respondents preferred to wait for better surgical alternatives, Duffey said.
Results showed that 33% of respondents have undergone laser vision correction (LVC) at some point in time, 29% had spouses who have had LVC, 28% had at least one child who has undergone LVC, and almost 60% had a sibling who has undergone LVC, Duffey said.
“I find this one fascinating, especially with some of the negative publicity of laser vision with the media over the last several years,” Duffey said.
Survey results showed that 97% of respondents were willing to perform bilateral LASIK at the same operating room visit and 96% were willing to perform bilateral surface ablation at the same visit, Duffey said. Five percent were willing to do bilateral refractive lens exchange, and 25% were willing to do bilateral phakic IOL implantation in one visit, he said.
Other findings
Regarding excimer lasers, 63% of respondents used the Visx (Abbott Medical Optics), 26% used the WaveLight (Alcon), and 7% used the Nidek model.
The IntraLase femtosecond laser (AMO) was preferred by 52% of respondents for flap creation; 6% preferred the Ziemer model, and 8% preferred other femtosecond lasers.
Results showed that 43% of respondents preferred the Zeiss Humphrey topography unit (Carl Zeiss Meditec), 41% preferred the Pentacam (Oculus), and 26% preferred the Orbscan (Bausch + Lomb).
Monovision was the preferred procedure for pre-cataract presbyopia among 41% of respondents, and 30% preferred modified monovision. Fifteen percent of respondents preferred multifocal IOLs, 4% preferred accommodating IOLs, 2% preferred blended conductive keratoplasty, and 1% preferred presbyLASIK.
“I find it reassuring that in observing presentations over the last 2 days [at this meeting] when the audience is being surveyed, the results for similar questions usually match this survey that we do professionally for the organization,” Duffey said.
The survey showed that 57% of respondents preferred a LASIK flap thickness of 100 µm. Sixty percent of respondents preferred a residual stromal bed of 275 µm or greater.
Fifty-six percent of respondents were willing to correct preoperative corneal astigmatism during cataract surgery when it reached 0.75 D and 80% were willing to correct corneal astigmatism of 1 D, Duffey said.
Sixteen percent of respondents reported having performed corneal collagen cross-linking through an investigational device exemption from the U.S. Food and Drug Administration. Cross-linking is not approved for use in the U.S. – by Matt Hasson