Emerging Trends for Procedure Selection in Contemporary Refractive Surgery: Consecutive Review of 200 Cases From a Single Center

PURPOSE To quantify emerging refractive surgery trends in a single refractive surgery practice. METHODS A retrospective chart review was performed of 200 consecutive candidates (377 eyes) for refractive surgery from July 20, 2007 to October 31, 2007. Patient age, manifest refraction spherical equivalent, pachymetry at the thinnest location (CCT), topographic symmetry patterns, and corneal apex location were analyzed. Patients were recommended sub-Bowman’s keratomileusis (SBK), photorefractive keratectomy (PRK), conductive keratoplasty (CK), phakic intraocular lens implants (PIOL) or refractive lens exchange (RLE). Corneal excimer procedures were either wavefront-optimized or wavefront-guided ablations. RESULTS Mean patient age for refractive surgery was 44±12 years (range: 18 to 68 years). The mean MRSE was –2.78±3.37 diopters (D) (range: –12.75 to +6.25 D). Of the 200 patients, 75% (n=151, 288 eyes) were recommended corneal excimer procedures. Of these, the mean CCT was 548±36 µm (range: 466 to 628 µm). Symmetric topographic patterns were observed in 54% (n=155) of eyes, whereas 32% (n=92) were borderline and 14% (n=41) were asymmetric. The corneal apex was centered in 79% (n=226) of eyes, whereas 18% (n=51) were borderline and 3% (n=10) were decentered (>2.5 mm from the center). Overall, 69% (n=139) of patients were recommended SBK, 16% (n=32) RLE, 6% (n=12) PRK, 5% (n=9) CK, and 4% (n=8) PIOL. Of the corneal excimer group, 88% (n=132) were scheduled for wavefront-optimized ablations and 12% (n=18) for wavefront-guided ablations. CONCLUSIONS Sub-Bowman’s keratomileusis was the predominant refractive surgical procedure offered in this practice, followed by RLE, PRK, CK, and finally PIOL. Of the corneal excimer procedures recommended, the majority of patients were scheduled for a wavefront- optimized ablation. [ J Refract Surg. 2008;24:S419-S423.] ABOUT THE AUTHORS From Durrie Vision, Overland Park, and the University of Kansas Medical Center, Department of Ophthalmology, Prairie Village, Kan. Dr Durrie is a consultant for Alcon Laboratories Inc, Ft Worth, Tex, and Advanced Medical Optics/IntraLase Corporation, Irvine, Calif. Dr Waring has no financial interest in the materials presented herein. Correspondence: Daniel S. Durrie, MD, Durrie Vision, 5520 College Blvd, Ste 201, Overland Park, KS 66211. Tel: 913.491.3330; Fax: 913.491.9650; E-mail: ddurrie@durrievision.com