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美国激光视力矫正25周年。

The 25th Anniversary of Laser Vision Correction in the United States.

作者信息

Joffe Stephen N

机构信息

History of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Department of Surgery and Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA.

出版信息

Clin Ophthalmol. 2021 Mar 17;15:1163-1172. doi: 10.2147/OPTH.S299752. eCollection 2021.

Abstract

Laser Vision Correction (LVC) is an elective, self-pay and safe surgical procedure to correct myopia and hyperopia. Since FDA approval 25 years ago, there have been a progression of technological improvements leading to better outcomes and LVC is now one of the safest surgical procedures. With a potential pool of 50 million patients, 6000 trained ophthalmic surgeons regularly treating in over 1000 centers of which 65% are physician owned. Treatments remain low from an earlier peak of 1.4 million to less than 800,000 over last 10 years. The factors preventing patients undergoing surgery have not changed and include the cost of $2000 ± $1000 per eye and fear of laser surgery on their eyes. The latter is overcome by word of mouth referrals and positive social media messaging. In addition, press misinformation and lack of optometrists participating in co-management have not helped grow LVC procedures despite the positive results of the FDA's Patient Reported Outcomes with LASIK studies known as PROWL. The surgery is quick, and patients can be "in and out" in less than two hours with a rapid recovery, minimal postoperative restrictions and within 24 hours have 20/20 vision. Volume and price drives center and physician profitability with a scheduling capacity of two to four patients' treatments per hour. Laser vision correction and especially LASIK, remains the treatment of choice for myopic and hyperopic patients wanting to remove their dependency on glasses and contact lenses.

摘要

激光视力矫正(LVC)是一种用于矫正近视和远视的选择性、自费且安全的外科手术。自25年前获得美国食品药品监督管理局(FDA)批准以来,技术不断进步,带来了更好的治疗效果,如今LVC已成为最安全的外科手术之一。潜在患者群体达5000万,6000名经过培训的眼科医生在1000多个中心定期开展治疗,其中65%的中心为医生所有。治疗量从早期的140万例的峰值下降,在过去10年中降至不到80万例。阻碍患者接受手术的因素没有改变,包括每只眼睛2000美元±1000美元的费用以及对眼睛激光手术的恐惧。后者可通过口碑推荐和积极的社交媒体信息得以克服。此外,尽管FDA的准分子激光原位角膜磨镶术患者报告结局研究(PROWL)取得了积极成果,但媒体的错误信息以及验光师缺乏参与共同管理,都无助于增加LVC手术量。该手术速度快,患者可在不到两小时内“进出”手术室,恢复迅速,术后限制极少,术后24小时内视力即可达到20/20。手术量和价格推动着中心和医生的盈利能力,每小时可安排两到四名患者接受治疗。激光视力矫正,尤其是准分子激光原位角膜磨镶术,仍然是希望摆脱对眼镜和隐形眼镜依赖的近视和远视患者的首选治疗方法。

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