ISRS 2013 U.S. Trends Survey

The 2013 U.S. Trends in Refractive Surgery Survey was completed by the ISRS membership in October 2013 with a 13% response rate. This was the seventeenth year of U.S. surgeon data collection and allows ISRS members from the United States to have their voices heard on refractive surgery.

Download the 2013 U.S. Trends Survey Presentation (PDF)

Summary of Results

• VisX (57%) losing further marketshare to Wavelight (34%).
• Still about 35% penetration of modern refractive surgery amongst refractive surgeons, 3-4x the general population. Family Index rates also continue to be high despite continued poor press regarding LVC in the public media over the past several years.
• 23% of respondents are OK with bilateral P-IOL and 8% with bilateral RLE at the same surgical setting (stable).
• Multifocal IOL (14%) over accommodative IOL (6%) as a preferred lens-based presbyopia option when used for RLE (stable).
• Femtosecond LASIK flaps still on the rise (73%)
• Thinner flaps dominate: 100 micron or less flaps are favored by 51% of surgeons (up from 12% in ‘04).
• Preferred RSB thickness is stable: 38% think 250 microns is adequate, but 62% recommend 275 microns or more.
• New post-LASIK ectasia cases continue to be on the decline with 47% stating no cases of their own patients in their career.
• Pentacam (45%) and Z-H (43%) about equal and Orbscan II stable near 30%.
• LVC Volume unchanged from last survey within ISRS/AAO membership in 2012, but consistently down over past five years.
• Ratio of Surface Ablation / Total LVC stable near 25% over past four years.
• During cataract surgery 67% of surgeons will offer to correct astigmatism if it measures 0.75 D or more; 90% if 1.25 D or nore.
• LRI/AK preferred (87%) if K astigmatism <1.0D
  Toric IOL preferred (75%) if K astigmatism > 1.12D
• CXL offered by 27% of ISRS members surveyed in the U.S. (not FDA-approved).
• FemtoSesond Laser-assisted Refractive Cataract Surgery on the rise.
  FS, Toric and PresbyIOL are not high volume refractive surgeries yet like LASIK in its heyday, but on the rise.
• Multifocals trump Accomodative IOLs, but neither high penetration.
• More astigmatism management (even low amt.) in cataract surgery.
• Healthy LVC Family Indices amongst refractive surgeons themselves.
• Post-LVC ectasia on the further decline.