Eyeworld

EW FEATURE 52 Patient satisfaction • December 2015 essential in order to optimize and adjust the outcomes. Laser vision correction When asked how they are current- ly assessing successful laser vision correction surgery outcomes in their practices, 20% of respondents said that they don't have a standard- ized way of assessing outcomes. U.S. ophthalmologists were 67% more likely than their international counterparts to not have a standard- ized way. Almost two-thirds (65%) use uncorrected visual acuity to assess outcomes, and respondents said that they look at the percent- age of patients with 20/20 or better uncorrected visual acuity. Addition- ally, 43% of respondents use patient satisfaction ratings, and 14% of non- U.S. ophthalmologists use visual quality contrast sensitivity testing. See Figure 2. According to Dr. Donaldson, "A successful laser vision correction outcome improves a patient's qual- ity of life on some level, whether it be freedom from glasses and con- tacts or improvements in vision. Although some of these outcomes are highly subjective, we can best quantify outcomes by analyzing visual acuity and analyzing pa- tient satisfaction survey scores. We measure our outcomes according to UCVA and BCVA," she said. In summary, patient satisfaction is essential to a successful practice. "A positive patient experience goes a long way toward publicizing and promoting your practice. Word-of- mouth referrals from one patient to another are one of the most effective marketing tools," Dr. Donaldson said. EW Editors' note: Dr. Donaldson has financial interests with Abbott Medical Optics (Abbott Park, Ill.), Alcon (Fort Worth, Texas), and Allergan (Dublin). Contact information Donaldson: KDonaldson@med.miami.edu by EyeWorld staff much more sensitive to residual refractive error compared to mono- focal IOLs. "Monofocal IOLs are much more 'forgiving' with regard to residual refractive error," she said. She offered the following pearls for refractive targeting in presbyopia patients: • In order to achieve the optimal refractive target, ophthalmologists should account for posterior cor- neal astigmatism, and they should make multiple preoperative keratometry measurements under optimal conditions. • There should only be one or two technicians performing the preoperative measurements, and the measurements should be made under optimal conditions (free of contact lenses and after pretreat- ment with artificial tears). • Additionally, the integration of technology and the constant analysis and reanalysis of results is According to Kendall E. Donaldson, MD, associate professor of ophthalmology, Bascom Palmer Eye Institute, Miami, the results are not surprising. "There have been several studies that have revealed that we really need to be within 0.5 D of plano to achieve our best surgical outcome. We may consid- er sphere and cylinder separately, but we should be considering the spherical equivalent and making sure that the spherical equivalent is less than 0.5 D as opposed to the sphere or cylinder alone. Patients are more tolerant of myopic resid- ual refractive error than hyperopic residual refractive error. Patients are also more tolerant of with-the-rule astigmatism as opposed to against- the-rule astigmatism," she said. Additionally, she noted that presbyopia-correcting IOLs, and more specifically the multifocal presbyopia-correcting lenses, are The importance of patient satisfaction ASCRS members weigh in I n the 2015 ASCRS Clinical Survey, ASCRS members were surveyed about their outcomes and the effect on patient satis- faction. Here are the results. Presbyopia-correcting IOLs Ophthalmologists were asked, "In patients implanted with a presby- opia-correcting IOL, what is the low- est amount of postoperative residual cylinder/spherical error that you consider to be visually significant?" With regard to residual cylinder, 62% of those surveyed think that 0.75 D of error is acceptable (54% for U.S. physicians and 72% for non- U.S. physicians). When asked about spherical error, 41% of respondents think that 0.75 D of error is acceptable (33% for U.S. physicians and 48% for non- U.S. physicians). See Figure 1. <0.5 D 0.5 D 0.51 D to 0.74 D 0.75 D 1 D >1 D 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% Cylinder All U.S. Non U.S. Average All 0.7 U.S. 0.7 Non U.S. 0.8 % All % U.S. % Non U.S. We don't have a standardized way of assessing outcomes 20% 25% 15% Uncorrected visual acuity—we look at the % of patients with 20/20 or better UCVA 65% 63% 67% Uncorrected visual acuity—we look at the % of patients with 20/16 or better UCVA 17% 18% 15% Ratio of patients with postop UCVA>preop BCVA 15% 11% 18% Patient satisfaction ratings 43% 39% 47% Visual quality contrast sensitivity testing 9% 5% 14% Global Trends in Ophthalmology ™ Copyright © 2015 Global Trends in Ophthalmology and the American Society of Cataract & Refractive Surgery. All rights reserved. ASCRS Clinical Survey Figure 1 55% 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% <0.5 D 0.5 D 0.51 D to 0.74 D 0.75 D 1 D >1 D Spherical All U.S. Non U.S. Average All 0.6 U.S. 0.6 Non U.S. 0.7 Figure 2

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