Eyeworld

32 Refractive surgery market might not rebound until 2020 or beyond, physician predicts W ith LASIK procedure numbers down across the U.S., a rebound in refractive surgery might not occur for another 5+ years, when the next generation that will be the best LASIK candidates will be the right age and have dispensable income to afford the procedure. Richard L. Lindstrom, MD, Minneapolis, moderated the "Refractive Surgery" symposium at Hawaiian Eye 2014, and presented an overview on the current situation of refractive surgery, "When will LASIK surgery rebound in the U.S. and why?" He said that his practice, Min- nesota Eye Consultants, did 7,700 LASIK cases in 2001. In 2013, the group performed approximately 2,800 to 3,000 cases. "Every year, it's been down. Where is the bottom number? What's going on?" he said. "The bad news is, the bottom is still a ways away." Dr. Lindstrom said that while physicians are still performing LASIK in the U.S., current numbers are not nearly comparable to what they were only a decade ago, and another rise in the market will take time. "Yes, we're all doing LASIK, yes, we're seeing a bunch of young pa- tients, but to really see ourselves climb out of this hole, I think we have a long way to go," he said. Main reason The main reason for the decline is demographics, Dr. Lindstrom said. When the excimer laser was first ap- proved, the age of the average Baby Boomer was 35 years old. That pa- tient was a pre-presbyopic myope, often with an established life and good job, so he or she could afford LASIK and was a good candidate for the laser procedure. But now, he said, the Millennial is the new refractive patient candi- date. This demographic cohort, often referred to as Generation Y, is typically placed after the Generation X demographic, and was born from the early 1980s to the early 2000s. This patient is often not currently in a good place financially for an elective surgery. Dr. Lindstrom refer- enced his children—who are in their late 20s and early 30s—and their friends, and how their generation is often not as well off as the Baby Boomers their age once were. "They're in debt. They're look- ing for a job. They're usually work- ing a job much less attractive than they'd like. They're just not quite there yet," Dr. Lindstrom said. These patients are also not yet ready to have refractive surgery be- cause of their younger age, he said. Many are still satisfied with wearing contact lenses and can afford the monthly cost of the lenses, but not the steeper cost of the refractive procedure. Data shows that they will want refractive surgery and that they are a big population potential for the pro- cedure, but they are not yet prepared to have it in large numbers. There are as many Millennials as there are Baby Boomers demographically, he said, and they are an exciting group for the procedure. Millennials say they will want the procedure in a higher percentage than the Baby Boomers had it. "They're not as afraid of it," he said. "Their comfort zone is higher than many of the Baby Boomers." What to do Several factors could assist in raising LASIK numbers soon, Dr. Lindstrom EW REFRACTIVE SURGERY 32 April 2014 by Erin L. Boyle EyeWorld Editor Millennials could have major impact on LASIK numbers

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