ISRS 2014 U.S. Trends Survey

The 2014 U.S. Trends in Refractive Surgery Survey was completed by the ISRS membership in October 2014 with a 15% response rate. This was the eighteenth 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 2014 U.S. Trends Survey Presentation (PDF)

Summary of Results

• VisX (50%) losing further marketshare to Wavelight (44%).
• Still about 35% penetration of modern refractive surgery amongst refractive surgeons, 3-4x the general population. Family Index rates also continue to be high.
• 23% of respondents are OK with bilateral P-IOL and 7% 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.
• Femtosecond LASIK flaps dominate and are stable at 71%.
• Thinner flaps dominate: 100 micron or less flaps are favored by 68% of surgeons (up from 12% in ‘04).
• Preferred RSB thickness is stable: 34% think 250 microns is adequate, but 65% recommend 275 microns or more.
• New post-LASIK ectasia cases show a slight rise in rate.
• Pentacam (42%) and Z-H (38%) about equal and Orbscan II dropped off to 28%.
• LVC Volume up over last two surveys in 2012 and 2013.
• Ratio of Surface Ablation / Total LVC stable near 22% over past five years.
• During cataract surgery 68% of surgeons will offer to correct astigmatism if it is 0.75 D or more; 97% if 1.25 D or more.
• LRI/AK preferred (91%) if K astigmatism <1.0D
• Toric IOL preferred (77%) if K astigmatism > 1.12D
• CXL offered by 23% of ISRS members surveyed in the U.S. (not FDA-approved).
• FemtoSecond 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 moving forward.
• Multifocals trump Accomodative IOLs, but neither high penetration.
• More astigmatism management (even low astig.) in cataract surgery.
• Healthy LVC and Premium IOL Family Indices amongst refractive surgeons themselves and their families.
• Post-LVC ectasia on a slight rise.