us trends in refractive surgery: 2002 ascrs survey richard j. duffey, md david leaming, md san...
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US TRENDS IN REFRACTIVE SURGERY: 2002 ASCRS
SURVEY
Richard J. Duffey, MDRichard J. Duffey, MDDavid Leaming, MDDavid Leaming, MD
San Francisco: April 12, 2002San Francisco: April 12, 2002
2002 SURVEY Sept. mailing to 5000 U.S. members of ASCRSSept. mailing to 5000 U.S. members of ASCRS 860 responses representing 17% of the U.S. ASCRS 860 responses representing 17% of the U.S. ASCRS
membershipmembership Sixth year of refractive data collection allowing Sixth year of refractive data collection allowing
analysis and comparison of trends amongst ASCRS analysis and comparison of trends amongst ASCRS U.S. surgeons U.S. surgeons
RK, AK, Cat/LRI, PRK, LASIK, LASEK, ICR, RK, AK, Cat/LRI, PRK, LASIK, LASEK, ICR, LTK, CK, P-IOL, CLE, SE, excimers, microkert., LTK, CK, P-IOL, CLE, SE, excimers, microkert., topogr., pupillometry, wavefronttopogr., pupillometry, wavefront
DUFFEY 2003
> 5 CASES / MONTH
0
15
2
34
2 0 0 1 0 1 005
1015202530354045
RK
Cat
/LR
I
PRK
LA
SIK
LA
SEK
ICR
LT
K
CK
P-IO
L
CL
E SE
'97'98'99'00'01'02
DUFFEY 2003
> 25 CASES / MONTH
0 1
15
00
5
10
15
20
25
RK PRK LASIK P-IOL
'97'98'99'00'01'02
DUFFEY 2003
> 75 CASES / MONTH
0 0
5
0
1
2
3
4
5
6
7
8
RK PRK LASIK
'97'98'99'00'01'02
DUFFEY 2003
PREFERRED SURGERY FOR 30 yo -3.00 DIOPTER MYOPE
1 4
79
3 0
12
0102030405060708090
RK PRK LASIK LASEK ICR WAIT
'97'98'99'00'01'02
DUFFEY 2003
PREFERRED SURGERY FOR 30 yo -7.00 DIOPTER MYOPE
0 1
87
3 18
0102030405060708090
100
RK PRK LASIK LASEK P-IOL WAIT
'97'98'99'00'01'02
DUFFEY 2003
PREFERRED SURGERY FOR 30 yo -12.00 DIOPTER MYOPE
2
21
2
15
7
52
0
10
20
30
40
50
60
PRK LASIK LASEK P-IOL CLE WAIT
'97'98'99'00'01'02
DUFFEY 2003
PREFERRED SURGERY FOR 45 yo +1.00 D HYPEROPE
1
48
2 38
1
37
05
101520253035404550
PRK
LA
SIK
LA
SEK
LT
K
CK
CL
E
WA
IT
'99'00'01'02
DUFFEY 2003
PREFERRED SURGERY FOR 45 yo +3.00 D HYPEROPE
1
63
2 1 3 17
21
0
10
20
30
40
50
60
70PR
K
LA
SIK
LA
SEK
LT
K
CK
P-IO
L
CL
E
WA
IT
'99'00'01'02
DUFFEY 2003
PREFERRED SURGERY FOR 45 yo +5.00 D HYPEROPE
0
17
05
27
49
0
10
20
30
40
50
60
70
PRK LASIK LASEK P-IOL CLE WAIT
'99'00'01'02
DUFFEY 2003
HAD REFRACTIVE SURGERY PERFORMED ON YOURSELF
3 3
10
0 0 0 0 0 00123456789
10R
K
PRK
LA
SIK
LA
SEK
ICR
LT
K
CK
P-IO
L
CL
E
'98'99'00'01'02
DUFFEY 2003
SURGEON WILLING TO DO BILATERAL AT SAME VISIT
59 61
95
69
4555 60
0 0
30
0102030405060708090
100R
K
PRK
LA
SIK
LA
SEK
ICR
LT
K
CK
P-IO
L
CL
E SE
'97'98'99'00'01'02
DUFFEY 2003
PRESENT and/or FUTURE PRACTICE PLANS
13
5869
45
14 12
39
6574
22
01020304050607080
RK
PRK
LA
SIK
LA
SEK
ICR
LT
K
CK
P-IO
L
CL
E SE
'01'02
DUFFEY 2003
TOPOGRAPHY UNIT OWNED
79
2116
9
37
125
01020304050607080
YE
S
Eye
Sys
Tom
ey
Alc
on
Zei
ss-
Hum
Orb
scan
Oth
er
'98'99'00'01'02
DUFFEY 2003
EXCIMER USED MOST
72
17
05 4 10
1020304050607080
Vis
X
Alc
on
Sum
mit
Nid
ek
B a
nd L
Las
erSi
gh
'97'98'99'00'01'02
DUFFEY 2003
MICROKERATOME USED MOST
58
312
4 4 2 4 49
1010203040506070
Han
sato
me
Mor
ia L
SK
Mor
ia C
B
Mor
ia D
isp
Mor
ia M
2
Inno
vato
me
SKB
M
Nid
ek
Am
adeu
s
Intr
alas
e
'98'99'00'01'02
DUFFEY 2003
Anticipated Value of Custom Laser Ablations
9
49
39
305
101520253035404550
Extreme Moderate Little None
'02
DUFFEY 2003
Wavefront Analyzer
89
61 1 1 10
102030405060708090
NO VisX Alcon B and L Tracey Other
'02
DUFFEY 2003
Pupil Gauge Instrument Use
58
30
6 6
0
10
20
30
40
50
60
Card Colvard Procyon Other
'02
DUFFEY 2003
Anticipated Surcharge to Patient for Custom Wavefront Laser Tx
61
17 9 6
16
0
10
20
30
40
50
60
70
Zero $100 $200 $300 $400 $500+
'02
DUFFEY 2003
Preferred Surgery for Presbyopia
53
32
12
1 0 0 00102030405060
Mon
ovis
Mic
rom
ono
Mul
tifoc
alIO
L SE
IR30
00
AC
S
Oth
er
'02
’02 ASCRS Survey Conclusions
LASIK dominates between -10D and +3DLASIK dominates between -10D and +3D Still awaiting the surgical solution for high Still awaiting the surgical solution for high
hyperopiahyperopia LASIK, CLE, P-IOL, and PRK all with apparent LASIK, CLE, P-IOL, and PRK all with apparent
bright futures bright futures RK, ICR, LTK dead or dyingRK, ICR, LTK dead or dying LASEK, CK and SE on the bubbleLASEK, CK and SE on the bubble Bilateral, same O.R. visit LASIK is S.O.C.Bilateral, same O.R. visit LASIK is S.O.C.
‘02 ASCRS Survey Conclusions VisX > 2:1 over all other lasers and wavefront VisX > 2:1 over all other lasers and wavefront
analyzersanalyzers Hansatome microkeratomes dominate the market with Hansatome microkeratomes dominate the market with
Moria following at distanceMoria following at distance Pupillometry 1:1 Instruments versus CardPupillometry 1:1 Instruments versus Card Orbscan is not S.O.C. require. for refrac. sxOrbscan is not S.O.C. require. for refrac. sx Monovision is still “choice” for presbyopiaMonovision is still “choice” for presbyopia Wavefront custom laser ablations are still in the future Wavefront custom laser ablations are still in the future
and their value is uncertainand their value is uncertain
Thanks to ASCRS leadership for their support and for your
participation in the 2002 Survey
We look forward to your responses in We look forward to your responses in the 2003 survey this autumnthe 2003 survey this autumn
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