Eyeworld

EW FEATURE 46 can be lengthy, but it's worth taking the time. "We can more specifically go after what patients' eyes are present- ing to us and what their desires are, and that's the beauty of having all of these choices," he said. Dr. Wiley said when you have more patients who are candidates for laser vision correction, thanks to more options expanding indica- tions, the whole field benefits. "Any time you take away a potential hurdle for one patient or classification of patients, it grows the market in a way that's exponen- tial where each patient who gets re- fractive surgery tells five or six other patients about their experience. The more patients going through that process, the larger the market gets across the board," Dr. Wiley said. "… even within the scope [of the procedure] if you increase satisfac- tion among patients, let's say you decrease even just a little bit of the dryness … that's less negatives out there." Not only have treatment tech- nologies improved, but diagnostics have improved to help physicians better match patients with the treatment that could yield the best outcome for them. Dr. Slade said a common problem is patients com- ing in not knowing what they're a candidate for. "People will spend years de- ciding what is best for them—PRK, LASIK, SMILE. They'll get on the internet, compare the different pro- cedures, and try to find out which is best, but they don't know which is best for them," Dr. Slade said. "We encourage people to come in and get a screening evaluation." From the physician side of it, Dr. Slade said you and your patients are better off if you stay up to date with technology. "You need to know about SMILE and you need to be able to intelli- gently answer questions about it. … Just like how [laser vision correction] is an elective procedure, buying a new laser, learning a new technique is an elective procedure or purchase, and you get to do it whenever you want." Dr. Wiley cautioned colleagues and industry against pitting one technique against another. "We don't want to get into a situation of pitting one technology against the other and saying, 'LASIK is bad and I have SMILE, my competitor down the road doesn't.' … I think being careful with how we apply the new technology, educate the patients, and market the procedures, we're better off if we market refractive surgery as a whole." EW References 1. Toda I, et al. Visual outcomes after LASIK using topography-guided vs. wavefront-guid- ed customized ablation systems. J Refract Surg. 2016;32:727–32. 2. Moshirfar M, et al. Small-incision lent- icule extraction. J Cataract Refract Surg. 2015;41:652–65. Editors' note: Dr. Manche has financial interests with Carl Zeiss Meditec and Johnson & Johnson Vision. Dr. Slade has financial interests with Alcon and Carl Zeiss Meditec. Dr. Thompson has financial interests with Alcon, Bausch + Lomb (Bridgewater, New Jersey), Carl Zeiss Meditec, and Johnson & Johnson Vision. Dr. Wiley has financial inter- ests with AcuFocus (Irvine, California), Alcon, Carl Zeiss Meditec, Johnson & Johnson Vision, Revision Optics (Lake Forest, California), and STAAR Surgical (Monrovia, California). Contact information Manche: edward.manche@stanford.edu Slade: sgs@visiontexas.com Thompson: vance.thompson@vancethompsonvision.com Wiley: drwiley@clevelandeyeclinic.com Register Now: www.icoph.org/WOC2018 New continued from page 45 " We can more specifically go after what patients' eyes are presenting to us and what their desires are, and that's the beauty of having all of these choices. " —Vance Thompson, MD

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