Refractive practices revealed in annual survey

November 15, 2004

New Orleans-"Hot-off-the-press" results from the 2004 International Society of Refractive Surgery of the American Academy of Ophthalmology (ISRS/AAO) refractive surgery survey are being examined to determine what constitutes standard of care, said Richard J. Duffey, MD, at the opening day session of the refractive subspecialty day meeting.

The expanded survey featured 32 items and introduced a number of new questions to gain insight on prevailing practices with respect to such issues as preferred flap thickness, the performance of measurements intraoperatively and for enhancements, and the acceptability of same-day bilateral surgery or surgery in monocular patients.

Among the findings, there were a few surprises, explained Dr. Duffey, who developed and analyzed the questionnaire in collaboration with David Leaming, MD.

The survey was mailed in August to 1,500 U.S. members of the ISRS/AAO. The results presented were based on 184 responses that were received by October 1. Of the respondents, 70% were doing at least five cases of LASIK per month and about 50% were performing more than 25 cases monthly.

Questions designed to identify preferred procedures for various indications showed that LASIK continues to be the dominant surgery for correcting refractive errors ranging from -8 to +3 D. For correction of high myopia, phakic IOL implantation was the surgery of choice among 40% of respondents, while refractive lens exchange was cited as the method of choice for treating high hyperopia by an even slightly higher proportion (43%). However, about one-third of the survey participants appear to be waiting for a better alternative for correcting extreme refractive errors, Dr. Duffey reported.

"We expect that the numbers of surgeons turning to lens-based surgery for high myopia and hyperopia will continue to increase in future surveys," he said.