U.S. Trends in Refractive Surgery: 2015 ISRS Survey
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1 U.S. Trends in Refractive Surgery: 215 ISRS Survey Richard J. Duffey, MD David Leaming, MD Refractive Subspecialty Day Las Vegas: November 13, 215
2 The authors have no financial interests in this survey study. DUFFEY/LEAMING 215
3 215 Survey Seventh year of ONLINE*** Survey ed to 122 U.S. ISRS members; 486 Opened Twentieth year of refractive data collection overall 55 responses analyzed by October 27, 215 for 9.8% response of the membership s opened requests Alphabet soup of refractive surgery including corneal and lens-based surgeries, premium IOLs, and FS cataract surg. DUFFEY/LEAMING 215
4 > 5 Cases / Month Surface Ablation LASIK RLE P-IOL K Inlay Toric Presby-IOL FS-Cat * ' '97 '4 '7 '11 DUFFEY/LEAMING 215
5 > 25 Cases / Month * ' Surface Ablation LASIK RLE P-IOL Toric Presby-IOL FS-Cat ' '3 '6 '1 '11 DUFFEY/LEAMING 215
6 Preferred Surgery For a 3 yo -1. Diopter Myope 5 * 44% LVC Never 9 15 Surface Ablation 29 4 LASIK RLE P-IOL WAIT 11 '5 '8 '11 DUFFEY/LEAMING 215
7 Preferred Surgery For a 45 yo +3. D Hyperope 1 *61% LVC 8 ' '2 '5 4 2 Never Surface Ablation LASIK RLE P-IOL WAIT '8 '11 DUFFEY/LEAMING 215
8 Preferred Surgery For 45 yo +5. D Hyperope 7 * '99 '2 '5 '8 2 1 Never 1 2 Surface Ablation 6 LASIK RLE P-IOL WAIT 8 '11 DUFFEY/LEAMING 215
9 Family LVC Index: (LASIK or PRK Performed on Yourself and Family Members) 8 7 * >3X the general population 6 5 ' Self Spouse Children At least 1 Sibling Parents 8 '9 '1 '11 DUFFEY/LEAMING 215
10 Excimer Laser Most Commonly Used VisX Wavelight B and L Schwind DUFFEY/LEAMING 215 '97 ' '3 '6 '9 '1 '11
11 FemtoSecond Cataract Laser Most Commonly Used LenSx Catalys LensAR Victus (B&L)
12 Flapmaker Most Commonly Used B-L Moria Amadeus Nidek B-D Intralase Ziemer Other FS 6 * 76% femtoflaps 53 '98 ' '4 '7 '1 '11 DUFFEY/LEAMING 215
13 Topography Unit Used (some physicians use more than one) Orb II Tomey Other Zeiss-Hum EyeSys Pentacam DUFFEY/LEAMING 215 '98 ' '4 '7 '1 '11
14 Preferred Surgery for Pre-Cataract Presbyopia '2 ' Mono Modified Monovision Accommodative IOL Multifocal IOL 12 Other 11 '7 '1 '11 DUFFEY/LEAMING 215
15 Minimum Residual Stromal Bed Thickness Requirement for LASIK * 61% at 275 microns or greater '4 '7 '8 '1 ' DUFFEY/LEAMING 215
16 Total Cases of Post LASIK Ectasia as the Primary Surgeon in Career * Continued Decline '4 '6 ' to 1 >1 4 '11 DUFFEY/LEAMING 215
17 Cataract/RLE Post-Op Antibiotic Tobra/Gent Fluoroquinolone Polytrim DUFFEY/LEAMING 215
18 LVC Post-Op Antibiotic Tobra/Gent Fluoroquinolone Polytrim 14 DUFFEY/LEAMING 215
19 Cataract/RLE Post-Op Steroid Pred FML Lotepr Dex Durezol DUFFEY/LEAMING 215 '6 '9 '1 '11
20 LVC Post-Op Steroid Pred FML Lotepr Dex Durezol '6 '9 '1 '11 DUFFEY/LEAMING 215
21 Threshold of Astigmatism Offered Correction at Cataract Surgery DUFFEY/LEAMING *68% will offer to correct astigmatism when it has reached.75 D and 97% when it has reached 1.25 D 4
22 Procedure for Low Astigmatism Intervention (.5 to 1. D) 7 * 86% LRI/AK Manual LRI/AK Femto/AK Toric 14 DUFFEY/LEAMING 215
23 Procedure for Medium Astigmatism Intervention (1.12 to 2. D) LRI/AK Femto/AK Toric DUFFEY/LEAMING 215
24 Procedure for High Astigmatism Intervention (2. D plus) LRI/AK Femto/AK Toric 1 DUFFEY/LEAMING 215
25 Do You Currently Perform CXL? Yes 22 No 78 DUFFEY/LEAMING 215
26 Overview of FS Cataract Surgery: % of All FS Cases of All FS Surgeons Primary Corneal Incision Secondary Corneal Incision Capsulorhexis Lens Fragmentation AK DUFFEY/LEAMING 215
27 Total LVC Volume in ISRS (x1) '8 '9 '1 '11 DUFFEY/LEAMING 215 Surface Ablation LASIK Total LVC *27% Decrease in Total LVC from 214. *Ratio of PRK / Total LVC stable at 28%.
28 215 ISRS FINAL SUMMARY FemtoSecond Laser-assisted Refractive Cataract Surgery up from 19% to 29% over the last year. FS, Toric and PresbyIOL are not high volume refractive surgeries yet like LASIK in its heyday, but moving forward. Multifocals trump Accommodative IOLs, but neither high penetration. More astigmatism management (even low) in cataract surgery. Healthy LVC and Premium IOL Family Indices amongst refractive surgeons themselves. Post-LVC ectasia on the decline. DUFFEY/LEAMING 215
29 Additional Data at Types and volumes of refractive surgeries currently being performed. Post-operative use of antibiotics, steroids, and NSAIDs. Surgical venues for various procedures and more. DUFFEY/LEAMING 215
30 Thanks to the ISRS leadership for their support and for your participation in this Final 215 Survey We Could Not Have Done It Without YOU!! ***Complete 2 years of survey results found at
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