Eyeworld

66 November 2016 EW REFRACTIVE and the public and our patients," Dr. Schallhorn said of the PROWL study. Dr. Schallhorn also discussed longer-term follow-up with LASIK. The PROWL study was a 3-month study, and there is still healing and adaptation that can occur after refractive surgery. He discussed a Journal of Cataract & Refractive Surgery study that looked at patient-reported outcomes after surgery of those who underwent LASIK. It included more than 2,500 patients and looked at 5-year follow-up results. This was a retrospective study, Dr. Schallhorn explained, with questions similar to those asked in the PROWL study. Even 5 years after surgery, the satisfaction rate is very high, he said. When physicians get satisfaction rates above 90% more than 5 years after surgery, that indicates a very favorable outcome, Dr. Schallhorn said. Patients in this study were asked about visual symptoms, how bothersome these symptoms were, and other factors that correlate to patient satisfaction. Dr. Dell said that there were very good results presented in both PROWL-1 and PROWL-2, notably unenhanced results. There were no enhancements allowed. He highlighted another study of LASIK looking at patients who wear daily wear contact lenses and patients at 1 year post-LASIK. There were more than 1,000 patients in each group. Looking at binocular distance vision, there were similar levels of acuity at the 20/20 level, but at the 20/16 level, there's an advantage for LASIK, Dr. Dell said. Dr. Dell added that risk in LASIK is a concern, but he stressed that in the most common alternative, contact lenses, there are also associ- ated risks. If you're presented with a dozen patients who wear daily wear contacts, expect that one patient has had multiple infections related to contact lenses, he said. For extended wear users, the risk is even higher. Webinar participants wrote in with questions about the studies dis- cussed. Dr. Schallhorn addressed the association between patient satisfac- tion results and specific refractive error. There is a relationship that has to do with the fact that the more refractive error there is, the lower the chance of 20/20 uncorrected vision, he said. There is a relation- ship between preoperative refractive error and postoperative uncorrected vision. The second point is interaction, Dr. Schallhorn added. If the patient has low refractive error but has refractive error postop, then the pa- tient is more likely to be dissatisfied. Another question was about re- sults in myopic and hyperopic LASIK groups. Although Dr. Dell noted that these two groups were not broken out in the PROWL study, in studies comparing myopia and hyperopia, myopia studies tend to produce more accurate results. EW Reference Schallhorn SC, et al. Patient-reported outcomes 5 years after laser in situ keratomileusis. J Cataract Refract Surg. 2016;42:879–889. Editors' note: Dr. Schallhorn has financial interests with AcuFocus (Irvine, California), Abbott Medical Optics (Abbott Park, Illinois), Ivantis (Irvine, California), and Carl Zeiss Meditec (Jena, Germany). Dr. Dell has financial interests with Presbyopia Therapies (Coronado, California), Optical Express (Glasgow, U.K.), Tracey Technologies (Houston), Advanced Tear Diagnostics (Birmingham, Alabama), Abbott Medical Optics, Bausch + Lomb (Bridgewater, New Jersey), and Lumenis (Yokneam, Israel). Contact information Dell: steven@dellmd.com Schallhorn: scschallhorn@yahoo.com (800) 367-8327 DuPont, WA 98327 info@lacrimedics.com • www.lacrimedics.com ©2016 Lacrimedics, Inc. 1 ASCRS Clinical Survey 2015. Global Trends in Ophthalmology and the American Society of Cataract and Refractive Surgery. 2 Offer valid through April 30, 2016. Don't let 41% of your patients with OSD go untreated, especially when they need something more than artifi cial tears. Lacrimedics' VisiPlug® is FDA approved for the treatment of the Dry Eye components of varying Ocular Surface Diseases (OSD) and after surgery to prevent complications due to Dry Eye Disease. VisiPlug® - Provides approximately 180 days of occlusion. Call 1-800-367-8327 and receive 15% OFF 2 your order! (Mention promo code OSD0416.) Don't let 41% of your patients 41% of refractive or cataract surgery patients have ocular surface dysfunction levels requiring some treatment beyond artifi cial tears! 1 0.4mm 0.5mm ASCRS continued from page 64

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