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Cover Focus | Apr 2015

The Future of Refractive Surgery

Since its introduction, LASIK has been a popular method of refractive correction and a welcome alternative to glasses and contact lenses for many patients. Of the millions who have undergone LASIK, the majority of patients are satisfied with their postoperative results.1-4 Some, however, complain of poor outcomes, report a significantly reduced quality of life, or experience visual side effects that necessitate retreatment or postoperative touchup procedures. Recent advances in excimer and femtosecond laser technologies and in customized ablation profiles have helped combat some of these issues; however, with rising patient expectations for postoperative results, these issues will certainly never disappear completely.

Are these the reasons why LASIK volume has decreased worldwide? Is it, alternatively, due to the economy or to the recent tactics of some LASIK providers to entice potential patients with lower prices and use bait-and-switch schemes, or is it the fact that LASIK as a procedure has simply reached its peak and is now on the decline?

This issue’s cover focus opens with Sheraz M. Daya, MD, FACP, FACS, FRCS(Ed), FRCOphth, exploring these questions and offering an overview of the product lifecycle and how it has affected LASIK. Ronald R. Krueger, MD, MSE, follows with an American perspective on the same topic. Other articles in this series explore alternative refractive surgery treatments, including small incision lenticule extraction and phakic IOLs. Taken collectively, these articles aim to answer the question: Will LASIK remain the king of refractive surgery, or will a newer procedure claim the No. 1 position?

— Laura Straub, Editor-in-Chief

1. Saragoussi D, Saragoussi JJ. LASIK, PRK and quality of vision: A study of prognostic factors and a satisfaction survey. J Fr Ophtalmol. 2004;27(7):755-764.

2. Bailey MD, Mitchell GL, Dhaliwal DK, et al. Patient satisfaction and visual symptoms after laser in situ keratomileusis. Ophthalmology. 2003;110(7):1371-1378.

3. McGhee CN, Craig JP, Sachdev N, et al. Functional, psychological, and satisfaction outcomes of laser in situ keratomileusis for high myopia. J Cataract Refract Surg. 2000;26(4):497-509.

4. Study On Post-LASIK Quality Of Life. http://www.medicalnewstoday.com/articles/103194.php. Accessed March 30, 2015.