Eyeworld

48 | EYEWORLD | SUMMER 2024 R EFRACTIVE by Ellen Stodola Editorial Co-Director About the physicians Lance Kugler, MD Kugler Vision Omaha, Nebraska Luke Rebenitsch, MD Medical Director ClearSight Oklahoma City, Oklahoma Vance Thompson, MD Vance Thompson Vision Sioux Falls, South Dakota Blake Williamson, MD Williamson Eye Center Baton Rouge, Louisiana our market for around 10 years on these addi- tional refractive surgery options. As a result, we have seen a significant uptick in patients asking for procedures by name rather than just LASIK." In his clinic, the volume of ICLs has in- creased over time, too, he said. When presented the option of the EVO ICL (STAAR Surgical) vs. LASIK, they are seeing more opting for the ICL. Dr. Rebenitsch thinks that LASIK is down because patients under the age of 40 are more affected by economic challenges than those over 40. Those under 40 don't have as much money as they used to, but Dr. Rebenitsch thinks it will bounce back. "Our March numbers were much better than February. I think this is just a tempo- rary drop in LASIK," he said. Refractive lens exchange is growing because it's something "new" that is being promoted by more surgeons and practices, and many patients are just hearing about it now. The outcomes of advanced technology IOLs are also much better than they were 5–10 years ago, he said. LASIK is here to stay for years, Dr. Re- benitsch said. "In years past, we only qualified 70–75% of people for LASIK; now, more than 90% of people who come to our clinic qualify for something, and that's fun as a refractive surgeon to have all those tools. It's good for patients, too, because they get better visual out- comes and a procedure more tailored to them." Vance Thompson, MD Dr. Thompson agreed that LASIK volumes are down across the country, including in his prac- tice. He does around 1,000 LASIK cases per year and in addition does a fair amount of refractive lens exchange and phakic IOLs. "It amazes me how many people come in for refractive surgery consultation, especially in their 50s–60s, who are still correctable at 20/20, so that's one criteria of LASIK, and they think that's what they want," he said. "But when you start talking with them about LASIK, one reason they're interested is they think it's going to help them with the reduction in low-light image quality that they're experiencing and/or presbyopia." He continued that when you educate them, they shift from wanting LASIK to wanting a lens replacement procedure. When they talk about L ASIK volumes in the U.S. have declined in the last year, but this isn't necessar- ily a bad thing, according to several EyeWorld Editorial Board members who commented on their recent observations with LASIK volumes compared to refractive surgery volume as a whole. Luke Rebenitsch, MD According to Dr. Rebenitsch, data shows LASIK is down between 10–15%, but overall refractive surgery is not down as much as that. There is some increase in lens-based procedures. Dr. Rebenitsch is seeing similar trends in his clinic. His clinic has been consistent with the national trends in LASIK in 2023 compared to 2022. In terms of marketing, Dr. Rebenitsch finds that LASIK is still the "catch-all" term for vision correction. The majority of the general public still sees LASIK as synonymous to vision correction. "But we have seen more and more people coming in asking for other options such as custom lens replacement and refractive lens exchange by name, knowing the options for presbyopia," he said. "We have been educating A decline in LASIK procedures: what this means for refractive surgery as a whole Dr. Rebenitsch performs RLE in his office-based surgery center. Source: Luke Rebenitsch, MD

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