ABSTRACT
Laser vision correction or LASIK has a long and excellent history with significant benefits and unlikely risks. Adequately educating patients should allay their fears and allow good candidates to enjoy the life changing benefits of improvement in the natural vision through laser vision correction.
Subject(s)
Communication , Keratomileusis, Laser In Situ/methods , Keratotomy, Radial/methods , Laser Therapy/methods , Myopia/surgery , Patient Education as Topic/methods , Humans , Keratomileusis, Laser In Situ/adverse effects , Keratomileusis, Laser In Situ/economics , Keratotomy, Radial/adverse effects , Keratotomy, Radial/economics , Laser Therapy/adverse effects , Laser Therapy/economics , Myopia/nursing , Myopia/psychology , Treatment OutcomeABSTRACT
This set of "Viewpoints" articles examines the relative merits of radial keratotomy (RK), photorefractive keratectomy (PRK), and laser assisted in-situ keratomileusis (LASIK). Drs. Rowsey and Morley review advances in RK techniques, long-term results, and complications, and explain why RK will remain a viable method for correction of moderate myopia, notably its minimal cost. Drs. Steinert and Bafna review both PRK and LASIK, discussing techniques and results and comparing their advantages and disadvantages with each other and with RK. Dr. Dutton, as "Viewpoints" section editor, summarizes clinical, technologic, and economic aspects of all three techniques, concluding that all will find a place among refractive surgeons for some time to come.
Subject(s)
Cornea/surgery , Keratotomy, Radial/methods , Myopia/surgery , History, 19th Century , History, 20th Century , Humans , Keratotomy, Radial/adverse effects , Keratotomy, Radial/economics , Keratotomy, Radial/history , Patient Selection , Refraction, OcularABSTRACT
PURPOSE: To determine the actual size of the refractive surgery market in the United States and to identify factors involved in the decision to have refractive surgery. SETTING: World Wide Web. METHODS: A survey was placed on the World Wide Web. Questions covered price sensitivity, preferred type of refractive procedure, and factors involved in the decision to have a refractive procedure. RESULTS: Average age of respondents was 34 years; refractions ranged from -0.50 diopter (D) to -12.00 D. The recommendation of ophthalmologist, friends, and relatives; the refractive surgeon's credentials; and office staff were critical factors in the decision-making. Sixty-six percent said they would have a refractive procedure if it were free. Only two said they would have photorefractive keratectomy (PRK) if it cost over $1500 per eye; none would have radial keratotomy (RK) if it were over $1500 per eye. Forty-eight percent rated their opinion of PRK as high to very high; 45% rated RK as high to very high. CONCLUSIONS: We conclude that the actual number of refractive procedures performed with the laser will be the same as before-between 100,000 and 250,000 annually. The survey suggests that PRK will share this potential market with RK, and the total number of potential patients converting to PRK may be considerably less than predicted unless the price falls to $500 per eye.
Subject(s)
Computer Communication Networks , Cornea/surgery , Health Services Needs and Demand/economics , Health Services Needs and Demand/statistics & numerical data , Health Surveys , Photorefractive Keratectomy/statistics & numerical data , Refractive Surgical Procedures , Adult , Costs and Cost Analysis/statistics & numerical data , Humans , Keratotomy, Radial/economics , Keratotomy, Radial/statistics & numerical data , Lasers, Excimer , Photorefractive Keratectomy/economicsSubject(s)
Practice Guidelines as Topic , Refractive Surgical Procedures , Ethics, Medical , Humans , Keratotomy, Radial/economics , Keratotomy, Radial/methods , Keratotomy, Radial/psychology , Lasers, Excimer , Photorefractive Keratectomy/economics , Photorefractive Keratectomy/methods , Photorefractive Keratectomy/psychology , Physician-Patient Relations , Professional Practice , Refractive Errors/psychologyABSTRACT
PURPOSE: To compare our current knowledge of the two most common current refractive surgical procedures for the correction of myopia. METHODS: I reviewed the scientific literature and my personal experience with radial keratotomy and excimer laser photorefractive keratectomy to compare these two modalities. RESULTS: Both radial keratotomy and photorefractive keratectomy are capable of permanently correcting myopic refractive errors. However, each procedure has its individual advantages and disadvantages, with the greatest concern currently being the effect of wound healing on refractive outcome. The procedures are not mutually exclusive. CONCLUSIONS: Both radial keratotomy and photorefractive keratectomy will be used to surgically correct myopia for the next several years until newer technology is developed to improve the predictability and stability of refractive results currently achieved with each procedure.
