Most refractive surgeons recognize that despite the large number of candidates for surgical vision correction, the number who opt for surgery remains relatively low. This is particularly true here in Germany, where consumers harbor skepticism about the safety and effectiveness of laser vision correction. In the experience within our clinics, we have demonstrated that a refractive surgery practice can grow by focusing on three key aspects: quality; offering the best and latest technology; and providing timely, relevant information to patients.
HIGHEST STANDARDS
When the founder of EuroEyes, Jørn Jørgensen, MD, of Denmark, opened his first clinic in 1994, he aimed to provide the highest standard of care. Now, the International Organization of Standards (ISO) certifies all 12 EuroEyes clinics. Taking the time to become ISO 9001 certified requires a great deal of commitment to achieve the required standards, which include consistently providing products or services that meet customer and applicable regulatory requirements and enhancing customer satisfaction through continual improvement of systems.
Six EuroEyes clinics have received Technischer Überwachungs-Verein/Technical Monitoring Association (TÜV; Munich, Germany) certification. The TÜV is a German monitoring organization that protects humans and the environment from hazards or unsafe products. Certification of LASIK clinics as well as surgeons is a recent initiative, originally proposed by our clinic, as a way to improve the standards of laser vision clinics throughout Germany.
The TÜV Süd certification parameters intend to guarantee a high standard in the surgical correction of refractive error using modern laser technology. The intent is to provide consumers with guidance when researching options for refractive surgery.
The EuroEyes Clinics have been among the first in Germany to undergo certification under the TÜV's stringent guidelines. Some considerations for certification include hygiene standards, technical equipment, operative routine, surgical experience, and complication rates.
The certification process requires that surgeons have performed more than 1,000 treatments in the past 5 years, 250 of which must have occurred in the past year. The examiners also check to see if diagnostic and surgical equipment used and procedures performed are state-of-the-art technologies.
EuroEyes clinics in Stuttgart, Hamburg, Berlin, and Leipzig received their TÜV certification earlier, with renewal occurring annually. The clinics in Hannover and Düsseldorf received certification in the autumn of 2007.
STAYING AT THE FOREFRONT
EuroEyes was among the first German clinics to perform outpatient, same-day cataract surgery. Although many considered bilateral LASIK as controversial when it was first introduced, we decided it was safe enough to perform. We were also in the forefront of performing wavefront-guided, all-laser LASIK. It is not about being the first to market once, it is about always being at the forefront.
EuroEyes clinics were the first in Germany to use the femtosecond laser. To date, we have five in use. Although many saw this laser as an unnecessary, additional LASIK expense, we saw that it made the procedure safer. Flap creation—the most critical step in LASIK—is where the majority of complications occur. Prior to the femtosecond laser, our rate of flap complications was approximately 1 in 500. With the femtosecond laser, flap complications are almost nonexistent. Even though the cost of the laser is high, we think patient safety should come first.
We also noted improved visual outcomes in eyes undergoing all-laser LASIK, particularly when combined with a wavefront-guided treatment. With the IntraLase FS Femtosecond Laser (Advanced Medical Optics, Inc. Santa Ana, California), the stromal bed is much smoother. Patients experience a faster visual recovery compared with when LASIK is performed with a mechanical microkeratome.1-3
A recent analysis of our results showed that 97.7% of eyes with a refractive error of -6.00 to -10.00 D and 98% of eyes with a refractive error of less than -6.00 D were within ±0.50 D of the intended correction.
The femtosecond laser does not differentiate EuroEyes from other clinics in Germany; the majority of laser vision clinics here now offer some form of all-laser LASIK. We were the first to adopt the technology, and we now have performed more than several thousand all-laser LASIK procedures.
Finally, we were the first clinic group in Germany to hire only full-time refractive surgeons, meaning that no ophthalmologist has a public health system practice. We believe this is a better approach because it provides continuity of care for patients. When a patient comes to our Stuttgart clinic, for example, they see me for the preoperative exam, the surgery, and the postoperative follow-up. It enables us to establish better trust with our patients.
A WELL-INFORMED PATIENT
In a perfect world, a clinic's reputation would be so renowned that marketing would be irrelevant. Unfortunately, this is not reality. In our experience, it can take anywhere from 5 to 10 years for the reputation of a clinic to take hold.
We also know that 80% to 90% of consumers who come to a EuroEyes clinic have researched their options and are aware of femtosecond laser technology. Of this group, 40% have arrived at our doors as a result of Internet research. As a population, Germans tend to be a conservative, well-informed group that knows what they want to do with their eyes.
Our marketing approach is heavily focused on providing educational information. We believe that a well-informed patient is the best patient because they can differentiate between a LASIK clinic, like EuroEyes, and a travel deal where LASIK is done cheaply in another country where the standard may not be as high.
We make certain that our Web site (www.euroeyes.de) is updated regularly with latest results from EuroEyes as well as international studies. Consumers can also post questions to our surgeons on the Web site.
We also hold regular informational evenings where people can talk to our surgeons and learn more about their refractive options, including refractive IOLs for presbyopia or astigmatism and bioptics.
Our goal is to be a patient-centered clinic with an individual approach that enables us to find the procedure that is best suited for the patient. We consider the patient's refractive error and lifestyle in our treatment decision. With this approach, EuroEyes has been able to grow its refractive procedure volume without compromising quality or patient care.
W. Eckhard Weingärtner, MD, is the Medical Director of the EuroEyes Clinic, Stuttgart, Germany. Dr. Weingärtner states that he occassionally receives travel grants from Advanced Medical Optics, Inc., but has no financial interest in the products or companies mentioned. He may be reached at stuttgart@euroeyes.de.
