CHANGING PRACTICE PATTERNS IN REFRACTIVE SURGERY - RESULTS OF A SURVEY OF THE MERICAN-SOCIETY-OF-CATARACT-AND-REFRACTIVE-SURGERY

A questionnaire on refractive surgical practice was sent to the entire membership of the American Society of Cataract and Refractive Surgery in 1992. One thousand eight hundred and forty-one (1,841) of the 4,95 0 members returned the survey for a response rate of 37.2%. The questi onnaire was designed to be self-administered and elicited information on types of refractive procedures performed in the survey year and the preceding year, as well as the intent to perform refractive procedure s in the future. Surgeons who perform radial keratotomy (RK) increased from 22% in 1991 to 30% in 1992; 45% expected to perform RK in 1993-1 994. The following categories of information were requested: character istics of RK patients, techniques used by the surgeon, characteristics of the surgeon's overall practice, type of RK training, surgical outc ome, and prevalence of complications. The results of this survey indic ate that the use of RK and astigmatic keratotomy (AK), as well as othe r refractive procedures, is steadily increasing. Radial keratotomy was mainly performed on patients 20 to 49 years of age who had low to mod erate myopia. The majority of surgeons used four to eight radials, cen trally directed incisions, and single depth settings. Three quarters o f the surveyed RK surgeons used the Casebeer nomogram. The survey resu lts indicated that 42% of surgeons performing photorefractive keratect omy (PRK) did not perform RK or other refractive procedures, suggestin g that growth in the practice of PRK following FDA approval may come f rom both current RK surgeons and novice refractive surgeons.