April 10, 2008, Chicago, IL--The American Society of Cataract and Refractive Surgery (ASCRS) announced at its annual meeting this week that it will participate in a post-LASIK quality of life study with the Joint LASIK Study Task Force, which includes the FDA, the National Eye Institute, ASCRS, and the American Academy of Ophthalmology. ASCRS also announced that the ASCRS Foundation has committed funds to support this effort.
Between 1998 and 2006, the FDA received a total of 140 comments relating to LASIK dissatisfaction, representing less than 1 in 10,000 U.S. LASIK patients. In 2006, the FDA re-evaluated symptoms and satisfaction data and reaffirmed that while the vast majority of LASIK patients were indeed satisfied with their outcomes, a few were not.
The Joint LASIK Study Task Force now will examine LASIK'S impact on the quality of patients' daily lives. Simply defined, quality of life refers to a patient's ability to perform the activities of daily living, everything from driving, daily routine, family life, career and sports performance, to personal appearance, after LASIK. While the FDA reports that nearly all patients are satisfied with their procedure, the study will seek to qualify LASIK's benefits and provide greater understanding of the very few patients whose expectations are not met with the procedure, with the goal of identifying ways to enhance patient care.
"To date, there have been few studies that looked specifically at quality of life. Most have focused on patient satisfaction, which is extraordinarily high for LASIK, but satisfaction is just one component of quality of life," said Kerry Solomon, MD, ASCRS co-chair of the Joint LASIK Study Task Force and professor of ophthalmology, Medical University of South Carolina. "The study will give us invaluable insight on the many and diverse factors that make up quality of life. This new knowledge will ultimately be a great benefit to patients and doctors alike."
Possible study outcomes could include a more holistic approach to patient screening and pre-operative patient counseling, with considerations for both physical and psychodynamic factors, as well as a better understanding of the myriad factors that comprise quality of life.
"The FDA deserves credit for orchestrating the Joint LASIK Study Task Force, and it has been a pleasure to work in concert with them, the NEI, and the AAO, to develop a study that will ensure patients get the most from America's most-popular elective procedure," said Richard L. Lindstrom, MD, co-chair of the Joint LASIK Study Task Force and immediate past president of the ASCRS. "When a procedure advances as far as LASIK has, both technologically and clinically, having a greater understanding of quality of life will help both patients and doctors, and could provide the next breakthrough in the procedure's performance."
In 2007, the Joint LASIK Study Task Force was formed to look into quality of life and the feasibility of a post-LASIK study. As part of this process, the FDA Ophthalmic Device Panel Medical Devices Advisory Committee will discuss post-market experience with both phakic intraocular lenses (phakic IOLs) and LASIK at its regularly scheduled April 24-25 meeting.
"People undergo LASIK to improve and enhance their quality of life. The LASIK procedure was designed specifically to improve patients' quality of life, and it has with great success for millions of people. What we are looking to do is study people that are satisfied with their procedure vs. people who aren't – even though this is a rare occasional patient. The more we can learn from that rare occasional patient, the better this procedure can be for everyone," said Dr. Solomon.
LASIK World Literature Review: Quality of Life and Patient Satisfaction
As part of this process, ASCRS set the task of reviewing information on satisfaction post-LASIK using a meta-analysis of the worldwide body of scientific literature on LASIK. Findings of the meta-analysis, announced last month, revealed a 95.4 percent patient satisfaction rate among LASIK patients worldwide.
"We found there is solid evidence in the world's scientific literature to affirm an exceptionally high level of satisfaction in patients who have had LASIK surgery – 95.4% in fact," said Dr. Solomon. "Importantly, these rates have been consistent over the past 10 years."
Led by Dr. Solomon, the meta-analysis examined approximately 3,000 peer-reviewed articles published over the past 10 years in clinical journals from around the world. Of those, a subset of 19 studies, comprising 2,200 patients, looked directly at satisfaction. All studies referenced in the global review were peer-reviewed and the resulting meta-analysis itself has been submitted for publication in a peer-reviewed medical journal. Dr. Solomon will present findings from LASIK World Literature Review: Quality of Life and Patient Satisfaction at the ASCRS Symposium.