Francis W. Price, Jr. MD. Indianapolis, Indiana - USA

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1 Survey Study: Satisfaction with LASIK vs. Contact Lenses for Vision Correction Preliminary 1 year results Francis W. Price, Jr. MD Marianne O. Price, PhD Indianapolis, Indiana - USA

2 Financial Disclosure I have the following financial interests or relationships to disclose: Consulting Fee: Alcon Laboratories, Inc.; Allergan, OPHTEC, Staar Surgical Speakers Bureau: Bausch + Lomb; Kedrion Biopharma; Oculus; Santen Pharmaceutical Co., Ltd. Ownership Interest: Calhoun Vision; ReVital Vision; TearLab Corporation Francis W. Price, Jr., MD

3 Financial Disclosure Study funded by participating practices and Cornea Research Foundation of America

4 Principal Investigators U.S.A. Frank Bucci, MD Wilkes-Barre, PA Brock Magruder, MD Orlando, FL William Bond, MD Pekin, Il Robert Lehmann, MD Nachdoghes, TX Nader Iskander, MD San Antonio, TX Britt Buckley, MD Colorado Springs CO Dan Durrie, MD Kansas City, KS Marc Werner, MD New York, NY Gary Foster, MD Ft Collins, CO Ettaleah Bluestein, MD Charleston, SC John Olkowski, MD EyeSight Hawaii, HI Michael Limberg, MD San Luis, CA Tom Abell, MD Lexington, KY Harvey Carter, MD Dallas, TX Michael Gordon, MD San Diego, CA Lawrence Katzen MD Palm Beach, Fl Jim Loden, MD Nashville, TN Albert Milauskas, MD Palm Springs, CA Mark Schneider, MD Cornona, CA Frank Price, MD Indianapolis, IN

5 International Sites Spain Jorge Alio Singapore Donald Tan, Jod Mehta, Kothubutheen Farook Brazil Renato Ambrosio, Rodrigo Santos

6 Purpose To compare patient satisfaction with Lasik and contact lenses for vision correction To establish a new benchmark by comparing Lasik with a popular alternative rather than a hypothetical ti perfect eye.

7 What was known Patients have good Snellen acuity with both Lasik and CL s Dry eyes are a problem in some people with Lasik and CL s

8 What was unknown How do dry eyes change over time? How is night vision after Lasik or with CL s? How happy are patients with Lasik and CL s?

9 What We Have Learned Satisfaction rate is high with both Lasik and CL s Lasik results in fewer vision problems with night driving For former CL wearers And for former spectacle wearers Dry eye complaints are common with Lasik, contact lenses, and even with those wearing glasses Dry eyes are under appreciated!

10 Design: Prospective Multi-center Survey Study Internet-based Self-reported outcomes Two arms: Lasik Pre-op, 1, 2, 3 years post op Contact t lenses Baseline, 1, 2, 3 years later

11 Inclusion/Exclusion l i Criteria i Inclusion criteria Age:18 to 60 years Require vision correction Exclusion criteria i Keratoconus Abnormal topography Multifocal treatment

12 Preliminary 1 year Results (As of 9/1/13) Total subjects enrolled: 1899 Responses to 1 year follow up survey so far 356 subjects who stayed in CL s 448 who wore CL s and had Lasik 154 who wore glasses and had Lasik 66% response rate

13 Question: I would recommend Lasik / contact lenses to a friend or family member?

14 Would recommend vision method Glasses users who CL users who CL users had LASIK (%) had LASIK (%) (%) Strongly Agree Agree Not sure Disagree Strongly Disagree P-value <

15 At this time, do you believe LASIK works better for you than wearing contact lenses?

16 LASIK works better for you than CL? Contact Lens users who had LASIK (%) Strongly Agree 83 Agree 13 Not sure 2 Disagree 1 Strongly Disagree

17 Do you have any difficulty driving at night because of your vision?

18 Vision cause difficulty with night driving Glasses users who had LASIK (%) CL users who had LASIK (%) Contact Lens users (%) Baseline 1 year Baseline 1 year Baseline 1 year Not at all A little Moderate Severe P<0.0001, 0001 LASIK reduced night driving difficulties

19 During the past week, have you experienced a feeling of dry eyes?

20 Dry eyes in past week Glasses users who had LASIK (%) CL users who had LASIK (%) CL users (%) Baseline 1 year Baseline 1 year Baseline 1 year Never Occasionally Half the time Most times All the time Compared with CL wearers, glasses wearers had less dry eye at baseline and bigger increase in dry eye symptoms after LASIK.

21 On average, how many times a day do you use artificial i tear drops in either eye?

22 Artificial tear use Glasses users who had LASIK (%) CL users who had LASIK (%) CL users (%) Baseline 1 year Baseline 1 year Baseline 1 year Never* / day x / day x / day Groups differed significantly: P< Artificial tear use increased after LASIK * 39% > 24% > 10%

23 Conclusions Study sets an appropriate benchmark for LASIK Compares 2 widely accepted treatments for refractive error LASIK and CL both entail some risk Both provide more functional and aesthetic correction than glasses Samples large number of people from across the country Lasik improves vision for night driving relative to both CL s and glasses There is a need for improved dry eye treatments for all forms of vision correction

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