1. Eun Kyoung Lee1,2, Young Keun Han1,2,3
Satisfaction level of the physicians who have undergone corneal refractive surgery
Eun Kyoung Lee1,2, Young Keun Han1,2,3
Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute1
Department of Ophthalmology, Seoul National University College of Medicine2
Department of Ophthalmology, Seoul National University Boramae Hospital3
The authors have no financial interest

2. Background & Purpose Corneal Refractive Surgeries Purpose
Is laser eye surgery still safe for doctors who
perform sophisticated operation??
“Mostly eye doctors wearing glasses..”
“Ophthalmologist, won't get LASIK even though
he offers it to his patients..”
Purpose
To evaluate satisfaction level of the physicians who have
undergone corneal refractive surgery
By comparing physicians with other healthcare workers &
By comparing medical physicians with surgeons

3. Patients and methods Retrospective comparative study
Between January 2005 and January 2010
Seoul National University Boramae Hospital
Surgical techniques
Corneal Refractive surgery: LASIK/LASEK
By same surgeon (Y.K.Han)
Patients
212 eyes of 107 patients
Age, Sex, Occupation, Medical subspecialties,
Types of corneal refractive surgery etc.
Group I: Physicians
Group I-A: Surgeons & Doctors using microscopes
Group I-B: Medical physicians
Group II: Other health-care workers (HCW’s)

4. Patients and methods Main outcome measure Statistical analysis
Clinical characteristics : SE (spherical equivalent), BCVA (best
corrected visual acuity) at preop & postop
Satisfaction about visual symptom after surgery
: Visual Function Index (VF-14) questionnaire
Statistical analysis
: SPSS 17.0
: Mann-Whitney U test, Paired t test
The VF-14, An Index of Functional Impairment in Patients With Cataract
Arch Ophthalmol vol 112, May 1994

5. Healthcare worker group
Results
Demographic data
Table 1. Preoperative patient characteristics
Variable
Physician group
Healthcare worker group
P – value
No. of patients 51 56 -
No. of eyes
100
112
Sex (M/F)
7/44
10/46
0.559*
Age (years)
mean
28.88 ± 2.80
27.88 ± 4.48
0.163†
range
24 ~ 37
23 ~ 41
Sphere (D)
-4.47 ± 1.82
-4.20 ± 1.57
0.415†
Cylinder (D)
-0.92 ± 0.61
-0.77 ± 0.68
0.218†
Spherical equivalent (D)
-4.93 ± 1.81
-4.58 ± 1.58
0.293†
Mean ± S.D.
*: Chi-square test
†: Student t test
212 eyes of 107 patients, M:F = 17:90
Group I (100 eyes of 51 pts): I-A (41 eyes of 21 pts), I-B (59 eyes of 30 pts)
Group II (112 eyes of 56 pts)
Mean age : ± 3.79 yrs (23~41yrs)

6. Healthcare worker group
Results
Demographic data
Table 2. Occupations and medical subspecialties
Physician group
Healthcare worker group
No.
(%)
Group A
Group B
Dentistry 5
23.8
Anesthesiology
16.7
Nurse assistant 17
30.4
General surgery 3
14.3
Dermatology 1
3.3
Office clerk 11
19.6
Laboratory medicine
4.8
Emergency medicine
Pharmacist
5.4
Obstetrics and gynecology
Family medicine 4
13.3
Registered nurse 25
44.6
Ophthalmology 2
9.5
Internal medicine
Orthopedic surgery
Pediatrics 10
Otorhinolaryngology
Psychiatry
Pathology
Radiology
Plastic surgery
Rehabilitation medicine
6.7
Urology
Therapeutic Radiation
Total 21
100 30 56
Group A = Surgeons or doctors using microscopes
Group B = Medical physicians

7. Results
Demographic data

8. Healthcare worker group
Results
Clinical characteristics
Table 3. Postoperative results of patients
Variable
Physician group
Healthcare worker group
P – value
UCVA (logMAR)
-0.10 ± 0.06
-0.11 ± 0.09
0.985†
Residual SE (D)
-0.04 ± 0.31
+0.01 ± 0.42
0.510†
Diameter of optical zone (mm)
6.11 ± 0.22
5.97 ± 0.82
0.215†
Residual corneal thickness (μm)
± 61.00
± 51.94
0.055†
Mean ± S.D.
*: Chi-square test
†: Student t test
There was no statistically significant between-group difference in clinical characteristics

9. Results Satisfaction about visual symptom after surgery
Table 4. Patient responses to questionnaire (Physicians vs. Healthcare workers)
Question
Mean score ± SD
P – value
Physicians
HCW's
Reading small print
3.61 ± 0.60
3.75 ± 0.58
0.217†
Reading normal newsprint
3.76 ± 0.51
3.79 ± 0.56
0.841†
Reading large newsprint
3.94 ± 0.24
3.95 ± 0.23
0.907†
Recognizing faces at a distance
3.96 ± 0.20
3.91 ± 0.35
0.365†
Going down stairs
3.90 ± 0.30
3.86 ± 0.40
0.518†
Reading street signs
3.76 ± 0.55
3.59 ± 0.78
0.180†
Sewing, doing delicate manual work
3.57 ± 0.64
3.61 ± 0.68
0.764†
Reading mail, bills accurately
3.71 ± 0.54
3.73 ± 0.49
0.792†
Playing cards
3.80 ± 0.40
3.73 ± 0.52
0.430†
Going out to movies, plays, sporting events
3.78 ± 0.50
0.613†
Cooking
3.82 ± 0.43
3.82 ± 0.47
0.981†
Watching TV
3.73 ± 0.57
3.80 ± 0.48
0.444†
Driving on day
3.59 ± 0.73
3.68 ± 0.61
0.485†
Driving at night
3.31 ± 0.97
3.18 ± 0.94
0.465†
†: Student t test
*P < .05
No statistically significant difference between Physicians and HCW’s group in all items of VF-14 questionnaires

10. Results Satisfaction about visual symptom after surgery
Table 5. Patient responses to questionnaire (Surgeons vs. Medical physicians)
Question
Mean score ± SD
P – value
Surgeons
Medical physicians
Reading small print
3.57 ± 0.68
3.63 ± 0.56
0.722†
Reading normal newsprint
3.76 ± 0.54
3.77 ± 0.50
0.974†
Reading large newsprint
3.90 ± 0.30
3.97 ± 0.18
0.365†
Recognizing faces at a distance
3.95 ± 0.22
0.801†
Going down stairs
3.90 ± 0.31
0.956†
Reading street signs
3.86 ± 0.48
3.70 ± 0.60
0.321†
Sewing, doing delicate manual work
3.62 ± 0.67
3.53 ± 0.63
0.643†
Reading mail, bills accurately
3.71 ± 0.56
3.70 ± 0.54
0.927†
Playing cards
3.76 ± 0.44
3.83 ± 0.38
0.537†
Going out to movies, plays, sporting events
3.80 ± 0.55
0.793†
Cooking
3.81 ± 0.40
3.83 ± 0.46
0.849†
Watching TV
3.80 ± 0.48
0.267†
Driving on day
3.50 ± 0.82
0.304†
Driving at night
3.43 ± 0.81
3.23 ± 1.07
0.485†
†: Student t test
*P < .05
No statistically significant difference between Surgeons and Medical physicians group in all items of VF-14 questionnaires

11. Conclusion & Discussion
No statistically significant difference in satisfaction level about visual symptom after corneal refractive surgery
between physicians and other healthcare workers
between surgical and medical physicians
High reliability of study was achieved by retrieving control group of healthcare workers who work under the same circumstance of same temperature and humidity with physicians group
It is conceivable that we may recommend corneal refractive surgery even to physicians who perform operation under bright light and use microscope for a long time

12. Reference
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2. Tuan K-mA. Visual experience and patient satisfaction with wavefront- guided laser in situ keratomileusis. Journal of Cataract & Refractive Surgery 2006;32:
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4. Williams L, Dave S, Moshirfar M. Correlation of visual outcome and patient satisfaction with preoperative keratometry after hyperopic laser in situ keratomileusis. Journal of Cataract & Refractive Surgery 2008;34:
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