Survey Says: Laser Vision Correction May Help You in Your Practice

By Ronald R. Krueger, MD, MSE

Without a doubt, we as physicians rely tremendously on our vision in our work. But we also tend to have realistic expectations about outcomes.

With that in mind, my colleagues and I decided to study the satisfaction rates of the many physicians on whom I have performed laser vision correction at the Cleveland Clinic Cole Eye Institute from 2000 to 2012. We believe this is the first such study to be done in the U.S.

What did we find? We were very pleased to learn that 96 percent said they would do it again and that, as a group, physicians seem to enjoy the same quality of life improvements from refractive surgery as the population at large.

Study design

We conducted a chart review that identified 226 physicians (429 eyes) who met the inclusion criteria (having undergone LASIK or PRK performed by me in the time frame specified). Exclusion criteria included having had refractive surgery at another institution, being unable to contact them or having a history of ocular surgery or disease unrelated to the laser vision correction.

Of these 226, all of whom we attempted to contact via email, 132 (58 percent) responded to the 12-question survey, which asked about their satisfaction and quality of life after laser vision correction.

What we learned

Would they do it again? Physicians resoundingly replied, “Yes!” The overall reported satisfaction rate from the survey was 95.3 percent.

These results give me enormous confidence in talking to physicians who are considering refractive surgery but have understandable concerns about their job-related visual needs. They can serve to increase their confidence too.

Our findings were published in the Journal of Cataract and Refractive Surgery in 2014. Here is a snapshot of what else we learned:

About 28 percent of respondents indicated that they perform surgery as part of their work and 43 percent said they perform procedures that require precision but not surgery. About 29 percent perform neither procedures nor surgery.

A total of 84.8 percent of respondents said they experienced an improvement in their quality of vision after refractive surgery compared with their best corrected vision before it. This is similar to satisfaction rates reported by those in the general population, who usually describe their vision as at least as good as or better than it was with correction before surgery.

Thirty-nine percent said that their ability to perform procedures accurately had improved. Only 1.6 percent felt that their ability to perform procedures had worsened.

Patients in the study had a mean age of 38.7 ± 7.5 years. The group was 63 percent male and 37 percent female. Their mean preoperative refractive error for the 420 eyes with myopia was -4.5 ± 2.16, with a range of 0 D to -11.5 D. There were nine hyperopic eyes, with a mean of +1.25 D ± 1.01 D; their range was +0.125 D to +3.25 D. Forty-three patients (19 percent) requested monovision. I performed LASIK on 382 of the eyes (89 percent) and PRK on 47 (11 percent).

Eight patients (6.2 percent) had an enhancement after their initial procedure. Twenty-eight (21.9 percent) continued to use spectacles after refractive surgery – 19 of them for near reading and 11 for driving at night, during rain or during another challenging condition.

More study is needed to confirm positive results

While we received overwhelmingly positive comments from the physicians who responded, our ability to generalize to a much larger physician patient base is limited by several factors. One is that all surgeries were performed by a single surgeon working at a single site. Also, since the responses were anonymous, there was no way for us to correlate them with actual visual outcomes. However, we felt anonymity was important because it encourages honesty.

Another issue is the amount of time that has passed since some of the respondents had their surgery. Memories can be inaccurate over time, and the aging process takes its own toll on visual acuity. This is part of the reason that we are planning to repeat the study in the near future, looking at a more recent group of refractive surgery-treated physicians (going back about 4 years) that was treated with our latest laser platform, the Alcon WaveLight Allegretto FS 200. The total pool of patients will be smaller but I have treated many more physicians in that time period and this new group may yield insightful new responses.