Survey weighs LASIK, contact lens wear

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LASIK results in fewer visual problems with night-time driving for patients who previously wore contact lenses and for those who wore glasses, indicate preliminary data from a survey comparing patient satisfaction.

Dr. Price

By Lynda Charters; Reviewed by Francis W. Price Jr., MD

Indianapolis-Preliminary data from a 3-year survey comparing satisfaction with LASIK and contact lenses found that patient satisfaction is high with both widely accepted treatments for refractive error.

LASIK results in fewer visual problems with night-time driving for patients who previously wore contact lenses and for those who wore glasses. However, dry eye can be problematic in some patients.

Francis W. Price Jr., MD, in private practice in Indianapolis, presented the preliminary 1-year results for the Cornea Research Foundation of America. The study, which was carried out at multiple centers across the United States and three international sites in Spain, Singapore, and Brazil, was an Internet-based, self-reported, prospective trial with two arms: the LASIK arm and the contact lens arm.

In the LASIK group, patients were evaluated preoperatively and 1, 2, and 3 years postoperatively. In the contact lenses group, patients were evaluated at baseline and 1, 2, and 3 years later, Dr. Price said.

Among 1,899 patients enrolled in the study,  responses to the 1-year follow-up survey thus far included 356 individuals who wore contact lenses, 448 who wore contact lenses and underwent LASIK, and 154 who wore glasses and underwent LASIK, for a 66% response rate, he noted.

What was asked in the survey

One of the survey questions asked respondents if they would recommend LASIK or contact lenses to a friend or family member. Among the patients who strongly agreed that they would do so, LASIK fared better than contact lenses in that 77% of patients who wore glasses and underwent LASIK and 87% of patients who wore contact lenses and underwent LASIK strongly agreed that they would recommend LASIK compared with 53% of contact lenses wearers who would recommend contact lenses. The difference in the percentages was highly significant (p < 0.001).

Another survey question (“At this time, do you believe that LASIK works better for you than contact lens wear?”) was aimed at patients who had worn contact lenses and then underwent LASIK. Eighty-three percent strongly agreed and 13% agreed that LASIK was better than contact lens wear.

Driving at night

A survey question that measured the degree of difficulty patients had with night driving garnered some interesting responses. The percentage of people who wore glasses and underwent LASIK and reported no problems with night-time driving rose from 39% at baseline to 54% 1 year after LASIK.

For subjects who wore contacts initially, the 41% who reported no problems with night-time driving at baseline increased to 62% 1 year after undergoing LASIK. Among the individuals who remained contact lens wearers, the respective percentages were 38% and 41%, essentially unchanged.

The percentages of individuals who reported severe problems with night-time driving were low and comparable among the three groups, Dr. Price pointed out, but he was especially surprised to see the degree of difficulty with night driving experienced by those who initially wore glasses before undergoing LASIK.

“Overall, LASIK significantly improves night driving,” he said.

A survey question about the frequency of the sensation of dry eye over the previous week showed that among those who claimed that they never experienced dry eye, there was a big decrease in the percent among those who wore glasses and then underwent LASIK, with the baseline result of 45% compared with 26% I year after LASIK.

Among individuals who wore contact lenses before undergoing LASIK, the difference was smaller at 54% and 40%, respectively. Those who continued wearing contact lenses reported the same percentages at baseline and 1 year later (29% and 30%, respectively). The percentages of patients who reported dry eye all the time increased slightly in the three groups.

A question about the daily frequency of artificial tears use showed the percentage of those who never use artificial tears dropped substantially in the group that initially wore glasses and underwent LASIK from 76% at baseline to 37% 1 year after LASIK; among those who wore contact lenses and then underwent LASIK the percentages went from 76% to 52%, respectively; and among those who continued contact lens wear the percentages went from 76% at baseline to 66% 1 year later. The differences among groups were significant (p < 0.0001).

In patients with severe dry eye who instilled tears more than five times daily, increases were seen mostly in patients who wore glasses and underwent LASIK. “Artificial tear use increased after LASIK,” Dr. Price said.

Benchmark for lasik

This study, which sampled a large number of patients across the country, sets an appropriate benchmark for LASIK, he added. It compared two widely accepted treatments for refractive error. LASIK and contact lens use both are associated with some risk. Both provide more functional and esthetic correction than glasses.

“Importantly, LASIK improves vision for night driving compared with contact lenses and glasses,” Dr. Price concluded. “There is a need for improved dry eye treatments for all forms of visual correction.”

Francis W. Price Jr., MD

E: fprice@pricevisiongroup.net

Dr. Price has no financial interest in the subject matter. The study was funded by the participating practices.

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