EyeWorld Asia-Pacific June 2016 Issue

June 2016 44 EWAP REFRACTIVE who had LASIK may now have it on their parents’ advice. Numbers also seem to be growing where small incision lenticule extraction (SMILE) is offered and where the clinic provides more than just laser eye surgery, he added. “Now we are treating young patients who become eligible for surgery in their late teens and early 20s,” Dr. Chang said, adding that another group that is growing is those with presbyopia. “Patients who have enjoyed good vision without glasses are fed up with reading glasses and now wish for spectacle freedom,” he said. “Therefore, presbyopia is another incentive for having surgery.” With worsening weather conditions and pollution, many are becoming intolerant of contacts lenses, Dr. Chang added. Dr. Kanellopoulos thinks that specialized LASIK procedures are growing. “The use of topography- guided technology appears to offer superior results clinically as far as visual acuity, quality of vision, and retaining asphericity of the eye,” he said. Where is it declining? The fact that LASIK has become so commercialized and is offered almost as a commodity is a reason that Dr. Kanellopoulos thinks LASIK may be declining. “This is probably perceived by the general public as a ‘product’ that is not desirable and not a top priority.” Dr. Cummings sees a decline in areas where the predominant providers are “high street based” and added that false and aggressive advertising and unrealistic promises undermine the value of LASIK. Because of the declining economy, the procedure is performed less frequently at present, Dr. Chang said, adding that LASIK is usually considered as a disposable income consumer product. “Most LASIK procedures go along with the local financial index,” he said. “When the financial index is high, patients have more disposable income, and LASIK is one of the procedures they often choose to have performed.” Recent negative publicity in Asia about the procedure may be having an adverse impact, Dr. Chang said. Another possible explanation is an increase in patient acceptance of the SMILE procedure; Dr. Chang thinks this may be causing some decline in LASIK. What can be done LASIK should only be performed in offices and premises of consultant ophthalmologists, according to Dr. Cummings. “The only indications are matching the patient needs with the most appropriate procedure, ensuring all inclusion criteria are met, and there should be no hard sell,” he said. Although some people think Views from Asia-Paci c WANG Zheng, MD Guangzhou Aier Eye Hospital 54 Zhongshan Road, Guangzhou, China Tel. no. +86-13903002594 gzstwang@gmail.com T he growth of refractive surgery volume has become slower in China in the past few years. While LASIK remains the mainstream, SMILE and ICL are having more and more shares in the market. The market here is a little different from the rest of the world. The average patient age is younger. Many are younger than 20 and the procedures often paid for by the parents. The main motivation of these patients is to have a better chance of getting a good job. For patients in this category, orthokeratology is another option, which is getting more and more popular recently. As the expectation for refractive surgery is very high, negative press usually has strong adverse impact and causes dramatic drop in the volume. The patients are better educated nowadays. On the other hand, however, they are often misled by biased information from the internet. Complications are often exaggerated, rumors are often widely spread. I don’t agree that laser vision correction is a commodity. It is a surgical procedure, after all. Though the safety record is excellent, severe complications sometimes do occur. According to a recent survey conducted by Aier Eye Hospital Group, 42% of the general population were unaware of refractive surgery, and 31% doubted the safety. So proper patient education is still necessary to deliver correct information about refractive surgery to the public. New technologies may bring positive in uence to the market. Novel procedures have attracted a lot of interest from patients. SMILE has been very successful commercially as a premium procedure in this region. In spite of slightly slower recovery and only comparable results, SMILE is considered to be “better and safer” than LASIK by many patients. More and more patients just come in asking for SMILE. Now more than half of my practice is SMILE, and it’s still growing. Editors’ note: Dr. Wang declared no relevant nancial interests. LASIK - from page 43