US Trends in Refractive Surgery: The 2007 ISRS/AAO Survey

1. US Trends in Refractive Surgery: The 2007 ISRS/AAO Survey Richard J. Duffey, MD ** David Leaming, MD Refractive Subspecialty Day New Orleans - November 10, 2007 ** TLCV provided partial funding for this survey

2. Lou Holtz “Rule of Tens” • Fewer than 10% of you will remember more than 10% of what I said more than 10 minutes after I said it… • So, look for the * DUFFEY 2007

3. 2007 Survey • August mailing to 1407 U.S. members of ISRS/AAO. • 248 responses analyzed by October 1st for 18% of the U.S. ISRS/AAO membership. • Eleventh year of refractive data collection. • Alphabet soup of refractive surgery including corneal and lens based surgeries. DUFFEY 2007

4. I Am Currently Doing This Surgery * * DUFFEY 2007

5. > 5 Cases / Month * DUFFEY 2007

6. > 25 Cases / Month DUFFEY 2007

7. > 75 Cases / Month DUFFEY 2007

8. Preferred Surgery For 30 yo -10.00 Diopter Myope * DUFFEY 2007

9. Preferred Surgery For 45 yo +3.00 D Hyperope * DUFFEY 2007

10. Preferred Surgery For 45 yo +5.00 D Hyperope * DUFFEY 2007

11. Surgery Done Bilateral At Same O.R. Visit * DUFFEY 2007

12. Had Refractive Surgery Performed on Yourself *32% DUFFEY 2007

13. Excimer Laser Most Commonly Used * DUFFEY 2007

14. Microkeratome Most Commonly Used *33% * *23% DUFFEY 2007

15. Topography Unit Most Commonly Used 1.43 units/respondent * DUFFEY 2007

16. Preferred Surgery for Presbyopia *61% *35% DUFFEY 2007

17. Wavefront Analyzer * DUFFEY 2007

18. Wavefront-Guided Custom Ablations in Your Practice * DUFFEY 2007

19. Preferred Flap Thickness (when no other constraints) * DUFFEY 2007

20. Minimum Residual Stromal Bed Thickness Requirement for LASIK * DUFFEY 2007

21. Total Cases of Post LASIK Ectasia as the Primary Surgeon in Career * Not growing DUFFEY 2007

22. Minimum Cent. Corneal Pachymetry for LASIK (all other parameters normal) * DUFFEY 2007

23. Mitomycin-C Use (MMC) * DUFFEY 2007

24. Location of Phakic-IOL Surgery DUFFEY 2007

25. 2007 ISRS/AAO SUMMARY • P-IOL(41%) and LASIK (32%) in high myopes. • VisXstill > 2:1 (69%) over all other lasers • Wavefront custom ablations are increasing with 92% of surgeons performing them (60% whenever possible). • 32%penetration of modern refractive surgery amongst refractive surgeons; 4 times the general population. DUFFEY 2007

26. 2007 ISRS/AAO SUMMARY • MMCuse on the rise (82%). • 10% of respondents are OK with bilateral P-IOL (6% last year) and 4% with bilateral RLE at the same surgical setting. • ReStor (16%) and ReZoom(10%) IOL’s slightly out-paced the CrystalensIOL(9%) for preferred lens-based presbyopia option. • Femtosecond laser use on the rise (28%). DUFFEY 2007

27. 2007 ISRS/AAO SUMMARY • Thinner flapson the rise; 100 micron flap thickness is favored by 27% of surgeons (up from 19%). • RSB Thickness on the rise; 62% think 250 microns is adequate, but 37% recommend 275 microns or more. • New post-LASIK ectasia cases are on the decline. DUFFEY 2007

28. Thanks to the ISRS/AAO leadership for their support and for your participation in the 2007 Survey We look forward to your response to the 2008 survey next fall Complete results at www.duffeylaser.com