Trends in refractive surgery in the United States.

To determine the latest trends in refractive surgery in the United States, a survey dealing with volumes, types, preferences, and use of emerging technology was sent to 5000 U.S. members of the American Society of Cataract and Refractive Surgery. Refractive surgery techniques and the use of lasers, microkeratomes, pupillometry instruments, postoperative medications, wavefront analyzers, and topographers were examined.

US trends in refractive surgery: 2002 ISRS survey.

PURPOSE: To determine the latest trends in refractive surgery in the United States. METHODS: The full U.S. membership of the International Society of Refractive Surgery (ISRS) (approximately 900 members) was mailed the 2002 refractive surgery survey dealing with volumes, types, preferences of refractive surgery performed, and use of emerging technology. RESULTS: Questions regarding RK, AK, PRK, LASIK, LASEK, intracorneal ring segments (ICRS), laser thermal keratoplasty (LTK), conductive keratoplasty (CK), phakic intraocular lenses (PIOL), and clear lens extractions (CLE) were examined in the survey. Procedure preference for low, moderate, and high myopia, and hyperopia, were compared with the results from the surveys of the previous 5 years. Preference for unilateral versus bilateral same-day surgery, laser type, and microkeratome choice were also compared with the survey data from previous years. Incidence and frequency of co-management of refractive surgery patients were compared with 1999-2001 data. New questions regarding pupil measurement/documentation, wavefront aberrometry, and custom ablations were incorporated into the 2002 survey. CONCLUSIONS: As refractive surgery grows in the mainstream of ophthalmology, trends and changes in the United States continue to be elucidated by this professional organization survey. LASIK continues to dominate for refractive errors between -10.00 to +3.00 D. LASIK, LASEK, CLE, PIOL, and CK appear to have bright futures, whereas, RK, ICR, and LTK are on the decline. VISX continues to be utilized 2:1 over all other lasers combined, and instrumentation pupillometry is preferred 2:1 over pupil gauge cards. Currently, wavefront aberrometry and custom ablations are minimally employed but appear poised to be the wave of the future.

Current trends in cataract and refractive surgery in Japan: 1999 survey.

PURPOSE: The eighth annual survey was carried out by mail in February 2000 to investigate the current trends in cataract and refractive surgery in Japan. RESPONDENTS: Questionnaires were sent to 930 ophthalmologist members of the Japanese Society of Cataract and Refractive Surgery. Data received from 457 (49.1%) of the recipients were cross-analyzed and compared with those from the previous surveys. RESULTS: In cataract surgery, 17% of respondents were doing 51 or more cases per month, 94% preferred phacoemulsification, 58% employed the self-sealing wound closure technique, and 26% used topical anesthesia for phacoemulsification. In refractive surgery, excimer laser surgery and astigmatic keratotomy attracted notably high interest, while less attention was directed toward radial keratotomy and intrastromal corneal ring. Laser in situ keratomileusis, photorefractive keratectomy, phakic intraocular lens, intrastromal corneal ring, and radial keratotomy were judged to be useful refractive surgical procedures by 69.0%, 40.0%, 24.6%, 14.2%, and 8.0% of the respondents, respectively. CONCLUSION: There are trends toward more surgical procedures performed by a surgeon, shorter period of hospitalization, and increasing preference for small incision cataract surgery. Refractive surgery is not yet widely performed, but laser in situ keratomileusis is viewed as the most promising procedure.

Practice styles and preferences of ASCRS members--2000 survey. American Society of Cataract and Refractive Surgery.

A survey of the practice styles and preferences of members of the American Society of Cataract and Refractive Surgery with a United States ZIP code was performed in August 2000. Approximately 26% (1400) of 5342 questionnaires mailed were returned prior to the november cutoff date. Three profile questions were used to cross-tabulate: age of the ophthalmologist, geographic location, and volume of cataract surgery per month. Current data were compared with data in previous surveys.

Current trends in cataract and refractive surgery in Japan: 1998 survey.

PURPOSE: A seventh annual survey was carried out by mail in February 1999 to investigate the current trends in cataract and refractive surgery in Japan. METHODS: Questionnaires were sent to 925 ophthalmologist members of the Japanese Society of Cataract and Refractive Surgery. Data received from 411 (44.4%) of the recipients were cross-analyzed and compared with those from the previous surveys. RESULTS: In cataract surgery, 93% of respondents preferred phacoemulsification, 58% employed the self-sealing wound closure technique, and 23% used topical anesthesia for phacoemulsification. CONCLUSIONS: There have been trends toward more surgical procedures performed by a surgeon, shorter period of hospitalization, and increased number of outpatient procedures. In refractive surgery, surgeons remained rather conservative; with 26% and 5% of surgeons doing astigmatic keratotomy and refractive keratotomy, respectively. Photorefractive keratectotomy, laser in situ keratomileusis, phakic intraocular lens, and intrastromal corneal ring were judged to be useful refractive surgical procedures by 58.2%, 69.5%, 25.4%, and 8. 8% of the respondents, respectively.

Current trends in cataract and refractive surgery in Japan: 1997 survey.

PURPOSE: A sixth annual survey was carried out by mail in January 1998, to investigate the current trends in cataract and refractive surgery in Japan. RESPONDENTS: Questionnaires were sent to 816 ophthalmologist members of the Japanese Society of Cataract and Refractive Surgery. Data received from 409 (50.1%) of the recipients were cross-analyzed and compared with those from the previous surveys. RESULTS AND CONCLUSION: In cataract surgery, there have been trends toward more surgical procedures performed by a surgeon, shorter period of hospitalization, and increased number of outpatient surgery. Ninety-two percent of respondents preferred phacoemulsification, 54% used the self-sealing wound-closure technique, and 19% used topical anesthesia for phacoemulsification. As for refractive surgery, surgeons remained rather conservative; with 28% and 7% of surgeons doing astigmatic keratotomy and refractive keratotomy, respectively. Photorefractive keratectomy, laser in situ keratomileusis, and phakic intraocular lens were judged to be useful refractive surgical procedures by 56.6%, 43.3%, and 25.1% of the respondents, respectively.

Corneal & refractive surgery.

Excimer lasers and high technology instrumentation have ushered in a new era of vision improvement surgery in Hawaii, replacing the more traditional forms of refractive surgery: cataract surgery, corneal transplant surgery, and radial keratotomy. Corneal surgery has been enhanced by new techniques of microsurgery and a more effective tissue procurement system for donor corneal tissue. Several laser centers provide the latest in FDA-approved excimer laser procedures including PRK and PTK. Mild to moderate myopia and astigmatism may now be corrected. Off-label use of LASIK, too, may soon be realized.

Practice styles and preferences of ASCRS members--1995 survey.

A survey of the practice styles and preferences of the 1995 members of the American Society of Cataract and Refractive Surgery with a U.S. ZIP code was performed in September 1995. Approximately 27% (1500) of the 5500 questionnaires mailed were returned by the December cutoff date. Four main profile questions were used to cross-tabulate data: age of the ophthalmologist, geographic location, volume of cataract surgery per month, and volume of refractive surgery per month. Current data were compared with data in previous annual surveys.

Practice styles and preferences of ASCRS members--1994 survey.

A survey of the practice styles and preferences of the 1994 members of the American Society of Cataract and Refractive Surgery who had a U.S. ZIP code was performed in September 1994. Approximately 32% (1569) of the 4849 questionnaires mailed out were returned by the November cutoff date. Four main profile questions were used to cross-tabulate: age of the ophthalmologist, geographic location, volume of cataract surgery per month, and volume of refractive surgery per month. This report also compared the data with previously published surveys.

Queratotomia radial: experiencia en el Hospital Nacional Cayetano Heredia / Radial keratotomy. Experience at the Hospital Nacional Cayetano Heredia

La queratotomia radial es un nuevo tratamiento quirurgico de la miopia simple. El proposito de este estudio ha sido evaluar los resultados de este procedimiento en el Hospital Nacional Cayetano Heredia desde agosto del 87 a diciembre del 89. La cirugia fue realizada en 44 ojos de 22 pacientes. 17 fueron femenino (77.3 por ciento) y cinco pacientes masculino (22.7 por ciento) la edad estuvo comprendida entre 20-39 años de edad. El promedio de la miopia pre-operatoria fue 3.9 +/- 1.8 dioptrias. La zona óptica fue 3mm en 31.8 por ciento y 3.5 mm en 68.2 por ciento de casos. El rango de la paquimetria central ultrasónica vario entre 0.41 a 0.63mm. El rango de la profundidad de las incisiones estuvo comprendido entre 0.44-0.64 mm. La agudeza visual postoperatorio a las 24 horas despues de la cirugia fue 20/20 a 20/40 en 68.2 por ciento de ojos; 20/50 a 20/70 en 11.4 por ciento de ojos; 20/100 a 20/200 en 20.4 por ciento. A los 30 dias postoperatorio la agudeza visual sin corrección fue 20/20 a 20/40 en 50 por ciento de ojos; 20/50 a 20/70 en 36.4 por ciento y 20/100 a 20/200 en 13.6 por ciento de ojos. La agudeza visual sin corrección a los 6 meses fue 20/20 a 20/40 en 43.2 por ciento; 20/50 a 20/70 en 38.6 por ciento y 20/100 a 20/200 en 18.2 por ciento de los ojos. Las complicaciones mas frecuentes en nuestra serie ha sido la hipo corrección. Se analiza cuidadosamente la miopia residual y podemos afirmar que la queratotomia radial disminuyó la miopia preoperatoria en todos los casos

Recent developments in refractive corneal surgery.

The 4- and 5-year results of the Prospective Evaluation of Radial Keratotomy Study reveal a hyperopic shift of more than 1.0 D within the follow-up time in 22% and 24%, respectively, of the eyes that underwent radial keratotomy. The number of eyes with this complication increased progressively from 6 months to 4 years. Attempts to correct this progressive hyperopia are discussed. Results of clinical studies of myopic photorefractive keratectomy performed with the excimer laser are reviewed. Regarding safety and short-term efficacy, photorefractive keratectomy is a promising technique. In the past, corneal topography has been interpreted qualitatively. Ray-tracing analysis now allows quantitative estimation of the influence of aspheric corneas on the degradation of the retinal image. Three approaches to correct hyperopia, radial thermokeratoplasty, laser thermokeratoplasty, and hexagonal keratotomy are reviewed and discussed. Additional concave intraocular lenses for correction of high myopia are still undergoing clinical evaluation. Endothelial damage is the most dangerous short-term complication of implantation with these lenses.