40 EyeWorld Asia-Pacific | September 2024 refractive procedure. We’ve also learned about the image quality enhancing power of the tear film, Dr. Thompson added. We’re more aggressive with tear film management and tear film health for therapeutic and optical reasons than we were 20 years ago. Blake Williamson, MD “We were down with LASIK 4%, but when we looked at our other procedures like custom lens replacement and ICLs, we were way up. We made massive gains on those two segments,” Dr. Williamson said. He thinks this is partly because his practice has been aggressively marketing custom lens exchange and ICL. “That 45-year-old patient who’s a little myopic, who may have gotten LASIK before, is coming in and saying, ‘I like the idea of seeing without reading glasses as well,’” he said, adding that these patients tend to lean to custom lens replacement. Similarly, that patient who’s always come in for LASIK, they come in because they heard an ad about EVO ICL, he said, adding that many people haven’t heard of the ICL before, even though it’s been an option for many years. Dr. Williamson said his previous marketing centered on LASIK, and now he’s trying to market EVO ICL and custom lens replacement. “This is not because we’re down on LASIK,” he said. “We love LASIK. It’s more about offering these people something else. They’ve heard about what we do over and over for 20 years. You don’t have to advertise LASIK anymore. What’s better is to advertise other things you’re doing. Give them something else, something new, something they’ve never heard of, something they can Google that piques their interest.” As a result of marketing other technologies, Dr. Williamson also thinks this will increase LASIK volumes as well. “I think because we marketed these other procedures and some people were a –1 or –2 and they could only have LASIK,” he said. “But at least I had the opportunity to have them in the chair and explain the benefits of modern LASIK, and if they had any hesitancy, I could try to understand that and advise them so they could make the right decision.” For patients who are around –1 up to –3, they can only have LASIK, Dr. Williamson said, adding that the ICL starts around –3. For a younger patient in their 20s, Dr. Williamson said he might recommend an ICL because chances are they’re going to have some refractive drift as they age. You can then do primary LASIK later, he said, instead of trying to lift an old flap or do PRK. In an older patient who is myopic, Dr. Williamson said he might lean toward doing LASIK if he’s anticipating doing a lens replacement for presbyopia in the near future. For someone with dry eye or a thinner cornea, Dr. Williamson is looking for any reason why LASIK might not be the perfect solution, yet ICL would provide the perfect solution. If they’re perfect for both an ICL and LASIK, we’ll offer both, and I’ll help them weigh the pros and cons, Dr. Williamson said, adding that some patients like the removability of the ICL. Other times they like that their parents had LASIK, and it worked great, and that’s the procedure they know and that’s what they want. “We’re doing more ICLs and lens replacement than we’ve ever done, and I think that’s catching on in our community and our state,” Dr. Williamson said, adding that he sees many out-of-town patients coming to him for these procedures. “They’re seeing ads on social media and hearing us talk about EVO ICL, and a lot of the time, they don’t have any doctors in their town doing it.” REFRACTIVE SURGERY Dr. Williamson implants the first Tecnis Odyssey toric IOL (Johnson & Johnson Vision), which is now his lens of choice for the custom lens replacement procedure. Source: Blake Williamson, MD Dr. Kugler performs RLE. Source: Lance Kugler, MD
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