Investigation of the Changes in Refractive Surgery Trends in Korea

Abstract

Purpose: To evaluate changes in clinical practice in the field of refractive surgery in Korea over the past 10 years.

Methods: A survey consisting of 59 multiple-choice questions regarding the preferred types of refractive surgery, excimer laser machine, and presbyopia surgery was mailed to 742 members of the Korean Society of Cataract and Refractive Surgery in January 2016, and 50 members responded to the survey. These data were compared with the 2005 or 2007 survey results.

Results: The majority of respondents were in their 40s (54%), and the average number of refractive surgeries performed in one month was 53. The most commonly used excimer laser machine was the VISX S4 in both 2005 (32%) and 2015 (25%); however, a greater variety of machines (EX500 [18%], Allegretto wave Eye-Q [13%], AMARIS 750 [10%]) were used in 2015. The preferred corneal refractive surgery in 2015 was surface ablation (40%), representing a significant increase in its popularity compared to 2005 (15%) (p < 0.001). The popularity of laser in situ keratomileusis (LASIK) surgery decreased to 20% in 2015 compared to 48% in 2005 (p < 0.001). Eighty percent of LASIK procedures in 2015 were performed using femtosecond laser. In 2015, surface ablation and phakic intraocular lens implantation were preferred for the treatment of myopia less than -8 diopters and more than -8 diopters, respectively. The proportion of respondents performing presbyopia surgery in 2015 (76%) was significantly increased from 2007 (30%) (p < 0.001).

Conclusions: Over the past decade, the most commonly performed corneal refractive surgery has changed from LASIK to surface ablation, and there has been a significant increase in the popularity of presbyopia surgery.

Keywords: Laser in situ keratomileusis; Laser-assisted subepithelial keratectomy; Presbyopia surgery; Refractive surgical procedures; Trends.

Fig. 1. Most commonly used excimer laser machines in 2005 and 2015.

Fig. 2. Preferred refractive surgeries in 2005 and 2015. LASIK = laser in situ keratomileusis; IOL = intraocular lens; SMILE = small incision lenticule extraction.

Fig. 3. Preferred refractive surgeries according to spherical equivalent in 2005 and 2015 (A) less than -4 diopters (D), (B) -4 to -8 D, (C) -8 to -12 D, (D) more than-12 D. LASIK = laser in situ keratomileusis; IOL = intraocular lens; SMILE = small incision lenticule extraction; CLE = clear lens extraction.

Fig. 4. Changes in respondents' perceptions regarding preoperative wavefront analysis in refractive surgery between 2005 and 2015. (A) Whether or not to perform wavefront analysis before refractive surgery. (B) Whether or not preoperative wavefront analysis results in better outcomes following refractive surgery.