Eyeworld

said. Crosslinking could be approved in the U.S. in the next year or two. Crosslinking and PRK or simultane- ous LASIK+ could expand refractive possibilities. In his practice, they have been turning away potential LASIK cases in 10% to 15% of pa- tients who have atypical corneas. A corneal inlay approved in the U.S. could assist in presbyopic Baby Boomer cases as well, he said. These patients have expressed interest in a procedure that offers functional near vision and good distance, which "could help cause a little bit of resurgence," he said. "Of course, as we do more re- fractive implants, we'll have to do more enhancements. But we're try- ing to get more one-stop shopping with our technologies so our enhancement rate goes down," Dr. Lindstrom said. What else can a refractive surgeon do in the face of stagnate LASIK numbers? Prices can be low- ered, but reduced price vs. volume does not always mean better num- bers, Dr. Lindstrom said, so that is not the most effective solution. Aggressive marketing might assist in growing refractive practices, but that also comes at a cost. "We used to be able to generate a LASIK eye for about $200 an eye in marketing, but nowadays it's about $800 to $1,000 an eye in marketing, so it's too expensive," he said. Practices might want to consider having someone younger or who understands the unique needs of this new generation to help in attracting younger patients through targeted marketing. Knowledge of social media is necessary for com- municating with and reaching the Millennial generation, he said, with many patients learning about poten- tial procedures through friends and on Twitter, Facebook, and other social media sites. However, the bottom line for in- creasing refractive surgery will most likely be waiting for the Millennials to not only get older but also "to get a little bit richer, to get a little bit better job, and to get a little less happy with their contact lens," Dr. Lindstrom said. "We all know as they age, they're going to burn out on their contact lens wear." "But they're coming. The ques- tion is, how long are you going to practice—will you be there when they get there? It's not next year. In my opinion, it's going to be about 2020." EW Editors' note: Dr. Lindstrom has finan- cial interests with Abbott Medical Optics (Santa Ana, Calif.), Alcon (Fort Worth, Texas), Bausch + Lomb (Rochester, N.Y.), and LENSAR (Orlando, Fla.). Contact information Lindstrom: rllindstrom@mneye.com EW REFRACTIVE SURGERY February 2011 33 WELCOME TO THE ERA OF CENTURION ® Active Fluidics ™ Automatically optimizes chamber stability by allowing surgeons to customize and control IOP throughout the procedure. Balanced Energy ™ Enhances cataract emulsification efficiency using OZil ® Intelligent Phaco and the INTREPID ® Balanced Tip design. Applied Integration ™ Designed to work seamlessly with other Alcon technologies for an integrated cataract procedure experience. Optimize every moment of your cataract removal procedure with the CENTURION ® Vision System. © 2014 Novartis 4/14 CNT13017JAD-A Learn more about the era of cataract procedures. Visit MyAlcon.com. For important safety information, please see adjacent page. 3:23 PM April 2014

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