The 25th Anniversary of Laser Vision Correction in the United States

Abstract

Laser Vision Correction (LVC) is an elective, self-pay and safe surgical procedure to correct myopia and hyperopia. Since FDA approval 25 years ago, there have been a progression of technological improvements leading to better outcomes and LVC is now one of the safest surgical procedures. With a potential pool of 50 million patients, 6000 trained ophthalmic surgeons regularly treating in over 1000 centers of which 65% are physician owned. Treatments remain low from an earlier peak of 1.4 million to less than 800,000 over last 10 years. The factors preventing patients undergoing surgery have not changed and include the cost of $2000 ± $1000 per eye and fear of laser surgery on their eyes. The latter is overcome by word of mouth referrals and positive social media messaging. In addition, press misinformation and lack of optometrists participating in co-management have not helped grow LVC procedures despite the positive results of the FDA's Patient Reported Outcomes with LASIK studies known as PROWL. The surgery is quick, and patients can be "in and out" in less than two hours with a rapid recovery, minimal postoperative restrictions and within 24 hours have 20/20 vision. Volume and price drives center and physician profitability with a scheduling capacity of two to four patients' treatments per hour. Laser vision correction and especially LASIK, remains the treatment of choice for myopic and hyperopic patients wanting to remove their dependency on glasses and contact lenses.

Keywords: Covid-19; LASIK; contacts; excimer; glasses; optical.

Figure 1

Vision disorders in USA. This figure demonstrates in a pie chart the percentage of patients with normal vision (30%), myopic (28%), hyperopic (15%) and presbyopic (26%).

Figure 2

Method of vision correction in USA. This figure demonstrates in a pie chart how vision is corrected on adults in the USA. Majority of adults wear glasses (50%), contact lenses (14%) and very few undergo laser vision correction (0.2%) each year.

Figure 3

Estimated laser vision correction (LASIK) procedures in USA 1996–2020. This figure is composed of multiple sources including personal experience and the publications of both private and public companies of how many laser vison correction procedures are performed each year in the USA since FDA approval.