MICS has made very little impact on US and EU surgeon practice

Microincision cataract surgery (MICS), hailed to be the next big development in cataract surgery, has not had the expected impact on surgeon's practice, David Leaming revealed, whilst detailing the results of his most recent survey on cataract surgery practice in Europe and the US.

Dr Leaming mailed out surveys to all EU members of ESCRS plus members from Bulgaria, Croatia, Norway, Romania, Russia, Switzerland, Turkey, Ukraine and Yugoslavia.

In total 3,083 surveys went out, with 733 returned, 24% response rate. Dr Leaming's analysis included cross comparisons between countries.

He also mailed out surveys to all US ASCRS members not in a training program. Total mail out was 4,645 with 723 returned, a16% response rate, with cross comparisons made for surgical volume.

In Europe, some 14% are doing some MICS, against just 4.4% in the US. Of the Europeans, those half use it in less than 20% of their cases, 13% use it 100% of the time, while 29% see themselves switching to MICS in the next year.

Across Europe, the percentage of surgeons doing LASIK refractive procedures is 28% overall. It's the most popular procedure in Spain, with 89% of surgeons performing it. In Turkey the figure is 68%, France 65%, Greece 57% and Ireland 57%. Phakic IOL implantations are performed by 24% overall, again the highest in Spain with 71%, France 53%, Germany 45%, Turkey 39% and Italy 30%. For Refractive lens exchange (RLE) there were 33% overall, again the highest in Spain with 71%, France 60%, Germany 55% and Italy 45%.

"The results show that there are some practice differences between the US and Europe, and the US leads in some areas while Europe leads in others," said Dr Leaming.

For example, phaco took off in the US a few years before it became common in Europe, while RLE took off in Europe first.

At next year's ASCRS congress, Dr Leaming will present his data along with the data from every other surgical practice survey currently running in Japan, Asia and Australasia in a series of posters. For the first time there will be a snapshot of surgical practice across the world.

Further information, a copy of the survey questionnaires and this year's survey results are all available at www.leamingsurveys.com.

Ophthalmology Times Europe reporting from the XXIV Congress of the ESCRS, London, 9-13 September, 2006.