2008 International Society of Refractive Surgery of the American Academy of Ophthalmology survey results show continuation of trends

January 1, 2009

Results of the 2008 International Society of Refractive Surgery/American Academy of Ophthalmology survey are consistent with market data showing a decline in the number of patients undergoing refractive surgery, but they demonstrate surgeon confidence in the procedure, with 35% of respondent surgeons having undergone LASIK or PRK in their own eyes. Use of the femtosecond laser for flap creation and preferences for thinner flaps and phakic IOLs for treating high myopia are growing.

Key Points

The 2008 survey represents the 12th consecutive year of data collection undertaken by Dr. Duffey and David Leaming, MD. In August, surveys including questions pertaining to the entire spectrum of refractive surgery procedures were mailed to the 1,364 members of the ISRS/AAO. At the AAO annual meeting, Dr. Duffey, a private practitioner in Mobile, AL, presented results based on analyses from surveys returned by 223 (16%) surgeons. The data are available online at http://www.duffeylaser.com/ .

Questions designed to get a snapshot of what procedures are being performed and how often showed that almost all of the respondents were performing LASIK and PRK (94% for both), a majority were performing limbal relaxing incisions (LRIs) in conjunction with IOL implantation (74%) or alone (62%), and about two-thirds were performing refractive lens exchange (RLE). All other procedures were being performed by fewer than half of the respondents, but the proportion performing phakic IOL implantation showed a steady rise over a 3-year period, reaching 43% in the current survey.

The results also showed a decrease in the proportion of high-volume LASIK surgeons-12% of the respondents indicated performing at least 75 cases per month.

"This trend for an ongoing decrease in high-volume LASIK surgeons dates back to 2001, and [it] follows population demographics and the steady decline in the consumer confidence index," Dr. Duffey said.

Although economic factors may be impacting the refractive surgery market, however, questions asking whether surgeons or their family members had undergone PRK or LASIK showed high penetration rates. Among surgeons, 35% reported having one of these procedures, and responses to a newly included question about family members showed that 30% of spouses, 21% of children, and 40% of siblings had vision correction with PRK or LASIK, he said.

"Considering that only about half of the responding surgeons might be eligible for refractive surgery, the finding that 35% of all respondents underwent surgery is quite significant," Dr. Duffey said.

"In fact, the penetration rate among the refractive surgeons is about four times that in the general public," he continued. "These data and the results for the proportions of family members reported to have undergone these procedures indicate that the more we know about the surgery, the higher the likelihood we are to have it ourselves and recommend it for our loved ones."

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