EyeWorld Asia-Pacific December 2016 Issue

December 2016 48 EWAP refractive 95% of them to be within 0.5 D,” Dr. Durrie said. “If that’s not happening, then I need to tighten my nomograms and my algorithms. There’s a variation in wound healing, but anytime we see something where there is a scatter in the database, there is opportunity. It says to me that preop refractions might be slightly off or nomograms might be slightly off.” Patient satisfaction It’s a scientific unlikelihood that LASIK satisfaction rates will ever reach 100%. “We don’t have a foolproof way to screen for personalities, and it is human nature not to be 100% satisfied,” Dr. Waring said. “Even with the outstanding lasers we have today, healing processes are unique to each patient and can be difficult to predict long term.” What it may take, he said, is improved metrics, understanding of epithelial and stromal remodeling processes, and intraoperative aberrometry. “We’re still basing our outcomes on Snellen acuity—a technology first described in the 1800s,” he said. Instead, he suggested clinicians start working with advanced diagnostics at quality of vision and “start looking at retinal image quality with double-passed wavefront. Look at the light, and analyze exactly what image is falling on a patient’s retina. That’s what will allow us to surpass 20/20 and get into 20/15, 20/12 super vision ranges with the next generation lasers, such as topography-guided LASIK and the higher resolution wavefront LASIK,” Dr. Waring said. In the Schallhorn analysis, 1,617 (63.9%) were very satisfied, 686 (27.1%) were satisfied, 100 (4.0%) were neither satisfied nor dissatisfied, 94 (3.7%) were dissatisfied, and 33 (1.3%) were very dissatisfied. 1 But the key for Dr. Durrie is how many respondents would have the surgery again if necessary: 2,396 patients (94.7%) responded affirmatively, 2,442 patients (96.5%) would recommend the procedure to their family or friends, and 2,410 patients (95.3%) thought the surgery improved the quality of their life. 1 The authors attributed lower patient satisfaction to worse postop binocular uncorrected distance vision, the presence and severity of visual symptoms, or postop spectacle/contact lens use, among others. Dr. Durrie does “in-depth patient satisfaction surveys on our patients. The most important question you can ask is if the patient would refer a relative or friend. In the last two quarters we’ve had a 100% positive response rate.” He attributes these stellar results to patient selection— preoperatively every surgeon spends about 20 minutes with the patient during the preliminary meeting, and the group “performs every test imaginable” to ensure there are no hidden abnormalities that would hinder outcomes. Dr. Waring also has “very high” patient satisfaction ratings and “very low” enhancement rates. Even among corneal refractive surgeons who have undergone refractive surgery themselves, more than 90% would recommend the surgery to family members. 2 ‘Real word’ - from page 47 Watch for our weekly emails every Saturday, broadcasting recorded live cornea presentations Learn from the experts @http:// Video Ed .CorneaSociety.org Copyright ©2016 Cornea Society. All rights reserved. The new Cornea Society Video Ed portal features cornea presentations and expert interviews from educational events throughout the year Watch, Learn & Share! Available on all mobile devices, tablets, and desktops All content is archived for future reference Watch, Learn, and Share! Video Ed