1. US TRENDS IN REFRACTIVE SURGERY:2003 ISRS/AAO SURVEY
Richard J. Duffey, MD
David Leaming, MD
ISRS/AAO Meeting
Anaheim- November 14, 2003

2. 2003 SURVEY
Sept. mailing to 1098 U.S. members of the newly combined ISRS/AAO
135 responses analyzed by Oct 15 for 12.5% of the U.S. ISRS/AAO membership
Seventh year of refractive data collection allowing an analysis of trends in US
RK, AK/LRI, PRK, LASIK, LASEK, ICR, LTK, CK, CLE, P-IOL, SE, excimer lasers, microker., topo., coman., postop meds, charges, pupillometry, custom abl., etc.

3. > 5 CASES / MONTH
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4. > 25 CASES / MONTH
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5. > 75 CASES / MONTH
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6. PREFERRED SURGERY FOR 30 yo -3.00 DIOPTER MYOPE
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7. PREFERRED SURGERY FOR 30 yo -7.00 DIOPTER MYOPE
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8. PREFERRED SURGERY FOR 30 yo -12.00 DIOPTER MYOPE
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9. PREFERRED SURGERY FOR 45 yo +1.00 D HYPEROPE
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10. PREFERRED SURGERY FOR 45 yo +3.00 D HYPEROPE
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11. PREFERRED SURGERY FOR 45 yo +5.00 D HYPEROPE
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12. SURGERY DONE BILATERAL AT SAME O.R. VISIT
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13. Procedure Future Index (Doing Now and/or Plan in Future)
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14. HAD REFRACTIVE SURGERY PERFORMED ON YOURSELF
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15. EXCIMER LASER MOST COMMONLY USED
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16. MICROKERATOME MOST COMMONLY USED
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17. TOPOGRAPHY UNIT MOST COMMONLY USED
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18. Pupil Gauge Instrument Use
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19. Value of Custom Ablation
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20. Wavefront Analyzer
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21. Wavefront-Guided Custom Ablations in Your Practice
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22. Increase in Charge for Custom
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23. Post-Op Antibiotic
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24. Post-Op Anti-inflammatory
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25. Comanagement
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26. ’03 ISRS/AAO SURVEY CONCLUSIONS
LASIK dominates between -8D and +3D.
Bilateral LASIK same O.R. visit is SOC.
P-IOL for high myopes.
CLE for high hyperopes.
LASIK, LASEK, CLE, P-IOL, PRK, CK all with apparent bright futures.
RK, ICR, LTK, and SE dead or dying.
DUFFEY 2003

27. Conclusions continued...
VisX at 2:1 over all other lasers.
Orbscan significant growth over last 2 yrs.
Intralase is increasing market share.
Pupillometry 2:1 IR instrument over card
Wavefront custom ablations rapid growth.
67% use wavefront analyzers.
58% perform custom ablations.
DUFFEY 2003

28. Conclusions continued...
Surgeons are charging $300-$500 more per eye for custom ablations.
Fourth generation fluoroquinolones have overtaken the post-refractive surg. market.
PF and FML lead post-op steroids/anti-inflammatories.
Co-management apparently decreasing.
DUFFEY 2003

29. Thanks to the new ISRS/AAO leadership for their support and for your participation in the Survey
We look forward to your response to the 2004 survey next fall
Complete results at and at