EyeWorld Asia-Pacific June 2013 Issue

49 EWAP rEfrActivE June 2013 Naval Aviator Study results An example of the results that can be achieved with laser vision correction can be seen in the Naval Aviator Study, which included 548 myopic eyes, 60 eyes with mixed astigmatism, and 24 eyes with hyperopia treated with iLASIK (Abbott Medical Optics, AMO, Santa Ana, Calif., USA). 2 At one day after surgery, 87% of myopic patients were seeing 20/16 or better, and more than half were seeing 20/12 or better. These results continued to improve at each follow-up visit. Regarding best-corrected visual acuity in the myopic patients, 6% were seeing 20/10, 65% were seeing 20/12, 99% were seeing 20/16, and 100% were seeing 20/20 pre-op. At 13 weeks post-op, 33% were seeing 20/10, 89% were seeing 20/12, 99% were seeing 20/16, and 100% were seeing 20/20. These results demonstrate a five-fold improvement in best- corrected vision at the 20/10 level, a remarkable achievement. From pre-op to one month post-op, approximately half of the eyes in each category (50% of myopic eyes, 50% of mixed astigmats, and 52% of hyperopes) had no change in mesopic low- contrast acuity, and 43% of myopes, 40% of mixed astigmats, and 33% of hyperopic eyes gained one line of mesopic low-contrast acuity. Additionally, the results from the LASIK in U.S. Naval Aviation Study showed average efficacy ratios of one or higher in 90% of all eyes by three months following surgery. Putting the efficacy ratio into practice At the 2012 American Academy of Ophthalmology meeting, a survey was taken after a panel discussion on this topic, and 65% of the audience said they would like to implement this testing in their practices. In a pre-registration survey, only 37% of attendees were testing laser vision correction patients beyond 20/20 and believed that it is important to do so, and only 6.5% used the efficacy ratio as a measure of success for laser vision correction in their practice. In the pre-test, before the discussion, 58% said their laser vision correction patients achieved an efficacy ratio of 1 or more at least 90% of the time. In the post-test survey, after the panel discussion, 40% said they would be comfortable/very comfortable talking about this ratio with patients. It is important to note that the efficacy ratio is a valid point of comparison to share with patients because they are thrilled to know that their uncorrected vision is better after surgery than it was before surgery with glasses. To implement these new measures in your practice, technicians and ODs must be trained to consistently push beyond the 20/20 line. Patient satisfaction can be increased by sharing the efficacy ratio and better than 20/20 results. In summary, the efficacy ratio is quick, easy, practical, and understandable, and it requires us to test our patients to the limit. EWAP Editors’ note: Dr. Tanzer is in private practice in San Diego. He has financial interests with AMO. references 1. Knorz MC, Vossmerbaeumer U. Comparison of flap adhesion strength using the Amadeus microkeratome and the IntraLase iFS femtosecond laser in rabbits. J Refract Surg . 2008 Nov;24(9):875-8. 2. Tanzer DJ, Brunstetter T, Zeber R, et al. A prospective evaluation of laser in situ keratomileusis in US Naval aviators. J Cataract Refract Surg . 2013, in press. contact information tanzer : DJTanzerMD@yahoo.com Experience the Keratograph 5M Topographer! Visit booth no. A12+13 at APACRS OCULUS presents the future in corneal topography and dry eye diagnosis! Find out what the new Keratograph 5M with colour camera and magnification changer can do for you and your patients! ThE PowER of ColouR ToPogRAPhy OCULUS Asia Ltd. Hong Kong Tel. +852 2987 1050 Fax +852 2987 1090 www.oculus.de • info@oculus.hk