Is refractive a reality?

[mmmmaaaaahhhhhh]

Hello all
Ophtho resident here (finishing R2) I am very interested in Cornea & external but predominantly in Refractive in particular (with an interest in KC as well).

What does a new Refractive surgeon "do" these days? I dont particularly enjoy general ophthalmology and my fear of doing a cornea fellowship is that I'd end up practicing mostly general with very occasional cornea work. I don't have a huge regional focus but ideally would like to practice refractive and cataract surgery in a midsize North American or UK city (flexible between Canada, the US and the UK/Scotland).

Can a young new grad get FT work doing mostly refractive cornea/cataract setting these days? Or is it a "sell your soul" to the big names and big companies deal? Or is it just a waste of time because the big names own the whole gig?

Thanks

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[RetinaDude]

just read where TLC has declared bankruptcy. They were one of the largest corporate refractive surgery centers in the US and Canada. I don't know much about the market for LASIK but this looks like a bad omen

 

[VA Hopeful Dr]

just read where TLC has declared bankruptcy. They were one of the largest corporate refractive surgery centers in the US and Canada. I don't know much about the market for LASIK but this looks like a bad omen

Look like that was driven to a decent extent by the huge volume drop from COVID.

 

[MstaKing10]

As a financial tool this probably saved them millions and they will come back in a different form once the dust settles.

Elective procedures on the whole took a big hit during the pandemic and obviously people falling on difficult financial situations meant they are less likely to pay for elective procedures out of pocket. Unless you believe these economic diffulties are permanent, I think lasik surgeons don’t need to worry long term. That said, the next 6-12 months (maybe longer) will be quite difficult.

 

[CECFellow2018]

Hello all
Ophtho resident here (finishing R2) I am very interested in Cornea & external but predominantly in Refractive in particular (with an interest in KC as well).

What does a new Refractive surgeon "do" these days? I dont particularly enjoy general ophthalmology and my fear of doing a cornea fellowship is that I'd end up practicing mostly general with very occasional cornea work. I don't have a huge regional focus but ideally would like to practice refractive and cataract surgery in a midsize North American or UK city (flexible between Canada, the US and the UK/Scotland).

Can a young new grad get FT work doing mostly refractive cornea/cataract setting these days? Or is it a "sell your soul" to the big names and big companies deal? Or is it just a waste of time because the big names own the whole gig?

Thanks

Volume is surprisingly high the last month. I don't work for a corporate center.
You should be seeking out a cataract/refractive surgery fellowship.

 

[Parkhurst Nuvision Fellow]

Volume is surprisingly high the last month. I don't work for a corporate center.
You should be seeking out a cataract/refractive surgery fellowship.

Agreed, volume is very very high right now. And I agree with CECFellow, if you are interested in refractive surgery, dont do a cornea fellowship, do a refractive/cataract/anterior segment fellowship.

 

[dantt]

Volume is surprisingly high the last month. I don't work for a corporate center.
You should be seeking out a cataract/refractive surgery fellowship.

Pent up demand due to office closures. It is magical thinking to think that overall volume will not decrease with the economy heading towards the worst recession in generations.

 

[CECFellow2018]

I suspect that the high volume in refractive is back log related. That said.
No one on this forum can predict much of anything or back up with evidence what they're hypothesizing. None of us know the extent of COVID on our futures and none of us know what procedures will "magically" increase or decrease in volume.
To OP: Pick something you like and become great at it. Things change for all physicians throughout their careers.

 

[Fascia Lata]

The type of LASIK/DALK/Cross-linking practices you see in the Middle East do not exist here. I can sort of tell you are from the Middle East wanting to move to the US? I did that. The practice patterns are vastly different. And surgeons here are rightfully way more conservative.