Why Cataract Surgery and No LASIK?

Early in my business career in Ophthalmology, I was observing a lot of cataract surgery and the field of Refractive Surgery was gaining traction with Radial Keratotomy (RK). A crude procedure when compared to today’s all laser method to performing LASIK.

I worked for Storz Instrument Company and it was the Fall of 1992. Storz was a surgical instrument company who was the market leader in surgical instruments for cataract surgery and also sold tools for performing RK.

One fine day while discussing cataract instruments with a surgeon, I asked him, “Are you a Refractive Surgeon, too?”

He looked at me rather coyly and said, “Son, you understand the crystalline lens makes up about 35% of the refractive power of the visual system, right? I take out cataracts and correct that dysfunction so therefore, yes, I am a Refractive Surgeon.”

I was young and trying to ask what I thought was a smart question to discover an opportunity. This doctor had put me in my place.

Since I didn’t know any better, I followed-up his statement with another question. I said, “You’re right, Doctor. And since we both know the cornea makes-up most of the rest of the refractive power of the visual system, what are you doing to help with that dysfunction in a myopic patient?”

This doctor was kind enough to not throw me out of his office for being a smart aleck and, instead, offered me the advice to ask Cataract Surgeon’s if “they do LASIK” instead of if “they are a refractive surgeon.” It was good advice and I am grateful for receiving it.

Many times during my subsequent twenty-five years in ophthalmology, I have thought about this comment. I sometimes wonder why every cataract surgeon does not do LASIK given the logic this physician described to me?

As I have witnessed the evolution of both LASIK and cataract procedures and patients seeking targeted outcomes in the correction of Dysfunctional Lens Syndrome, I am beginning to wonder how a Cataract Surgeon today is not a LASIK Surgeon? It’s a missed opportunity for sure.

Market estimates indicate Corporate LASIK comprises as much as 25% of the total market. These patients certainly have a connection to an ophthalmologist somewhere. Why are competent surgeons letting this significant revenue stream slip away?

Do they know they can access a full suite of equipment to offer the procedure to their patients right in their practice for as few as three patients per month? And if they don’t want to do that, at least find an open access center to bring your patients and be a comprehensive Refractive Surgeon.

There, that’s how I’ll ask it now, “Are you a comprehensive Refractive Surgeon?” Only time will tell where that gets me……


  1. Russ Vitaliano on April 26, 2016 at 4:53 pm

    hey Joel. I think the reason most general ophthalmologists dont do LASIK is because the companies arent doing a good job of educating them about why its a good procedure to take another look at. they have such a sub-specialty mentality, that most dont think its their comfort zone. all laser LASIK should change their thinking in an open access or roll on roll off setting to offset costs. remeber that when you and I came into this business doctors used to do almost all procedures. the sub-specilties have taken that away, and made it more difficult for them and us!

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