42 EyeWorld Asia-Pacific | September 2024 About the Physicians Lance Kugler, MD | Kugler Vision, Omaha, Nebraska | lkugler@kuglervision.com Luke Rebenitsch, MD | Medical Director, ClearSight, Oklahoma City, Oklahoma | dr.luke@clearsight.com Vance Thompson, MD | Vance Thompson Vision, Sioux Falls, South Dakota | vance.thompson@vancethompsonvision.com Blake Williamson, MD | Williamson Eye Center, Baton Rouge, Louisiana | blakewilliamson@weceye.com Relevant Disclosures Kugler: None Rebenitsch: Carl Zeiss Meditec, Johnson & Johnson Vision, OSRX Pharmaceuticals, RxSight, STAAR Surgical Thompson: Alcon, Bausch + Lomb, BVI, Carl Zeiss Meditec, Johnson & Johnson Vision, Lenstec, Rayner, RxSight, STAAR Surgical Williamson: Bausch + Lomb, Johnson & Johnson Vision, STAAR Surgical This article originally appeared in the June 2024 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. REFRACTIVE SURGERY ASIA-PACIFIC PERSPECTIVES Chan Wing Kwong, MD Partner & Senior Consultant, Eye & Retina Surgeons 1 Orchard Boulevard, #13-03 Camden Medical, Singapore 248649 cwk@ers.clinic LASIK numbers are not just declining in the US. The same is observed by surgeons and industry partners in the Asia Pacific region. While everyone has a pet theory as to why this is occurring, I think this is largely due to a host of contributing factors, rather than there being a single clear reason. 1. Pent up demand driving the LASIK boom is over. LASIK was wildly successful when it was introduced 30 years ago, as it was the best and most accurate refractive surgery procedure we could offer, with extremely high levels of patient and surgeon satisfaction. Those from the baby boomer and generation X demographic who were inclined to have LASIK have already had it done. What we are now seeing is a steady state of demand for LASIK, or indeed any other refractive surgical procedure. 2. Increasing popularity of other refractive surgical procedures. In the last decade, procedures such as phakic intraocular lenses, intrastromal lenticule extraction and refractive lens exchange have gained traction, inevitably driving some of the potential LASIK patients toward these alternatives. This is particularly true in China and India where there is a large population with increasing purchasing power and information to make choices on refractive surgery. 3. Change in population demographics. Millennials are now in the age where they might be considering refractive surgery. Why don’t we see them have LASIK in the numbers of previous generations? It is hard to be certain, but perhaps they are still waiting for the “next best surgery”, perhaps they are just confused by all the different procedures that are being bandied around and taking a wait and see attitude, maybe they are just not that averse to using spectacles and contact lenses and would rather spend their disposable income on something else. 4. Commoditization of LASIK. We remember all too well the LASIK price wars of the years gone by. Numerous players discounted LASIK prices to such unsustainable levels in a race to the bottom. LASIK prices have recovered somewhat but the potential patient at the sidelines may now still be waiting for the next offer of a discount or price war to break out. The lesson we can all learn from this is to charge for our surgical expertise and professional services in a sustainable manner. The lesson in economics we can learn from is LASIK (or any other refractive surgical procedure) demand is inelastic. In other words, lowering the price of a procedure does not increase demand. The LASIK market is now in a steady state of equilibrium. Refractive surgeons will have to adapt and adjust their practices to offer what appeals to and works best for their patient demographics without compromising on the results, safety or patient interests. Editors’ note: Dr. Chan Wing Kwong disclosed no relevant financial interests.
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