March 2014

 

REFRACTIVE SURGERY

 

LASIK vs. contact lens wear compared in study


by Ellen Stodola EyeWorld Staff Writer

 
 

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LASIK is a popular option for those seeking vision correction, and a new study set out to measure patient satisfaction with the procedure compared to contact lens wear. Francis Price Jr., MD, Price Vision Group, Indianapolis, is one of those leading the study, which incorporates 20 sites in the United States and three international sites in Spain, Singapore, and Brazil.

"The purpose of this study is to compare patient satisfaction with LASIK and contact lenses for vision correction and to establish a new benchmark to compare LASIK with a popular alternative rather than a hypothetical perfect eye," Dr. Price said at the 2013 American Academy of Ophthalmology (AAO) meeting. He discussed results of the study, looking at the one-year results of a comparison of LASIK and contact lenses in patients, primarily highlighting the results from the United States.

Previous beliefs and factors

Before the study was undertaken, it was known that patients generally have good Snellen acuity with both LASIK and contact lenses and that dry eyes can be a problem for both of these types of patients.

There were several points that were unknown before the study as well, including how dry eyes change over time, the quality of night vision after LASIK and with contacts, and how happy patients are with LASIK and contacts.

Dr. Price said that based on the results of the study, the satisfaction rate among patients was high with both LASIK and contact lenses.

"LASIK results in fewer vision problems with night driving both with former contact lens wearers and former spectacle wearers," he said. In addition, complaints about dry eye were common among those who wear glasses, contact lenses, and who received LASIK. "I think that overall we greatly underappreciate how significant dry eyes are in our population," he said.

The study

The study itself is an internet-based prospective study with two arms, Dr. Price explained. The LASIK patients were evaluated preoperatively, the contact lenses at baseline, and then they are resurveyed at one, two, and three years. The data he spoke about was preliminary one-year data.

Patients involved in the study were between the ages of 18 and 60. Those excluded were patients with keratoconus, abnormal topographies, or multifocal treatments.

The results he spoke about included 356 people who stayed in contact lenses, 448 who wore contacts and then had LASIK, and 154 who wore glasses and then had LASIK. The questions posed The study posed several questions to patients to gauge satisfaction and results. One question was whether or not patients would recommend LASIK or contact lenses to a friend or family member. Dr. Price said there was a high agreement rate for both vision correction methods.

The next question asked whether patients believed that LASIK works better than wearing contact lenses. "We had 83% strongly agree and 13% agree, so overall 96% of the people thought LASIK was better for them than contacts," he said.

Other questions addressed night driving and dry eyes. Patients were asked if they had difficulty driving at night because of their vision, and Dr. Price specifically focused on the groups of people who either had no problems driving at night and those who had severe problems.

Dr. Price noted that the reported rate of night driving problems decreased after LASIK both among those who had previously worn glasses and those who had used contact lenses. "We see that the percentage of people having no problems [who previously had] glasses went from 39% to 54%, a 15% improvement among those who previously wore glasses," he said. "For those in contacts, it improved by 21%." He added that those who stayed in contacts showed virtually no change. The percentage with severe problems was small and did not change significantly after LASIK.

"Overall LASIK improves night driving vision and that was very significant," he said.

To assess dry eye, patients were asked how often in the past week they had experienced dry eye symptoms. They were also asked about the number of times a day they use artificial tears. The percentages of patients reporting dry eye symptoms were higher than expected among both glasses and contact lens wearers and the percentage increased more after LASIK in those who formerly wore glasses.

Conclusion

"This study sets an appropriate benchmark for LASIK," Dr. Price said. "It compares two widely accepted treatments for refractive error." LASIK and contact lenses both entail some risk. "Both provide more functional and aesthetic correction than glasses," he said.

Dr. Price noted that the information from this study is important to help put LASIK into the correct perspective. "It's also important to realize that LASIK improves vision for night driving relative to both contacts and glasses, and very importantly, there's a need for improved dry eye treatments for all forms of visual correction."

Follow-up

"To our knowledge, this is the first time a longitudinal prospective study has been done to assess vision and satisfaction with LASIK and contact lenses," Dr. Price said. "Before we were just looking at the final refractive results patients have, and as time has gone by, there's been a move by some people to compare LASIK to an emmetropic perfect eye that probably doesn't exist." "I think as clinicians, we have some general ideas on how things are going to be, but I was surprised with a number of the results," Dr. Price said. Although doctors tend to see patients who are experiencing problems, it was nice to see how patients were doing overall. He added that an interesting aspect of the study is that it gauges only patient response and doesn't factor in the opinions of the doctors doing the procedures.

Editors' note: Dr. Price has no financial interests related to this article.

Contact information

Price: fprice@pricevisiongroup.net

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