Understanding new insights on patient experiences after LASIK

Indianapolis-A study designed to set an appropriate benchmark for LASIK is generating interesting findings in a preliminary analysis of outcomes at 1 year, said Francis Price Jr., MD.

The prospective, Internet-based survey study is under way at multiple centers across the United States and three international sites. It is funded solely by the participating practices and the Cornea Research Foundation of America. Eligible patients are 18 to 60 years old who require some vision correction, are not seeking multifocal treatment, and do not have keratoconus or abnormal topography.

Patients are administered surveys at enrollment with questions about satisfaction with vision correction, vision difficulties, and complications, and are being surveyed again after 1, 2, and 3 years, according to Dr. Price, president and founder, Cornea Research Foundation of America, and in private practice, Indianapolis.

“We know both LASIK and contact lens wear provide more functional and aesthetic correction than glasses, but both LASIK and contact lenses entail some risk,” he said. “We are very excited about the study and believe it will greatly expand our understanding of the issues people have with both LASIK and contact lenses.”

As of Sept. 2013, the study had enrolled its target population of 2,000 patients wearing spectacles or contact lenses. Responses to a follow-up survey at 1 year were available from 460 subjects who stayed in contact lenses, 579 patients who went from wearing contact lenses to have LASIK, and 199 patients who wore glasses at entry and then had LASIK.

The 1-year data showed that among patients who went on to LASIK and those who stayed in contact lenses, nearly all (96% to 98%) would recommend their current vision correction method to a family member or friend. However, the proportion of patients who would strongly recommend their current method of vision correction was much higher among patients who went from glasses or contact lenses to LASIK (77% and 87%, respectively) compared to those who stayed with their contact lenses (53%).

Reinforcing patient satisfaction with LASIK were data showing that 96% of former contact lenses wearers who had LASIK answered affirmatively to the question, “At this time, do you believe LASIK works better for you than wearing contact lenses?”

The study also found that LASIK had a benefit of reducing night-driving difficulties whether patients were previously in glasses or in contact lenses. At baseline, about 60% of patients said they experienced at least a little difficulty driving at night because of vision within all three study groups (glasses to LASIK, contact lenses to LASIK, or continued contact lens wear). After 1 year, the proportion of patients having any vision-related night-driving difficulty was reduced to 46% among patients who had gone from glasses to LASIK, and to 38% in those who had switched from contacts to LASIK, but it was relatively unchanged among patients who stayed in contacts.

Questions about dry eye showed that compared with contact lens wearers, those in glasses had less dry eye at baseline, but a bigger increase in dry eye symptoms after LASIK. Patterns of artificial tear use were consistent with the responses to the question on dry eye symptoms, showing an increase in artificial tear use after LASIK and more so in patients who wore glasses previously than among those who had been in contact lenses.

“The data on dry eye indicate that dry eye complaints are common among patients needing vision correction,” Dr. Price said. “The prevalence is probably widely underappreciated and speaks to a need for better dry eye treatments.”

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