Successful Business of Refractive Surgery in a Private Setting in 7 - - PowerPoint PPT Presentation

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Successful Business of Refractive Surgery in a Private Setting in 7 - - PowerPoint PPT Presentation

Mar 07, 2024 426 likes •689 views

Successful Business of Refractive Surgery in a Private Setting in 7 Minutes By Detlev R. H. Breyer Bilder von Fotograf Schadow Arkaden und Oberkassel Breyer, Kaymak & Klabe Eye Surgery and Premium Eyes are Consulting, Study Center & MAB

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SLIDE 1

Breyer, Kaymak & Klabe Eye Surgery and Premium Eyes are Consulting, Study Center & MAB for: Abott, Alcon, AlimeraSciences, Allergan, AMO, Bayer, Carl Zeiss Meditec, Ellex, Fluoron, Geuder, iOptics, LensAR, Medicem, Novartis, Oculentis, Oertli, Revision Optics, Santen, Staar Surgical, Sifi Medtech, Thea, Topcon, Visufarma, Ziemer

Successful Business of Refractive Surgery in a Private Setting in 7 Minutes

By Detlev R. H. Breyer

Bilder von Fotograf Schadow Arkaden und Oberkassel

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SLIDE 2
  • Dr. med.

Detlev Breyer

  • Dr. med.

Hakan Kaymak

  • Dr. med.

Karsten Klabe

  • Dr. rer. nat.

Philipp Hagen

  • Prof. Dr. med.

Gerd U. Auffarth

  • Dr. rer. nat.

Andreas Fricke

  • Dr. med. Florian
  • T. A. Kretz

Who am I? to tell YOU this…

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SLIDE 3

Who am I? Usually a Surgeon and Scientist

  • Started 15 years ago with a non surgical private practice
  • Today over 10.000 intraocular cases
  • From cataract refractive, DMEK, glaucoma surgery to complex vitreoretinal
  • „Anything but tumors“
  • Own science institute with 3 fully employed phycisist, chemist and biologist
  • Consulting, study center, speaker, MAB for over 15 companies
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SLIDE 4

How Are Other Successful Private Refractive Settings?

  • International leading refractive surgeon and successful entrepreneur
  • Dan Reinstein
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SLIDE 5

Breyer, Kaymak & Klabe Eye Surgery and Premium Eyes are Consulting, Study Center & MAB for: Abott, Alcon, AlimeraSciences, Allergan, AMO, Bayer, Carl Zeiss Meditec, Ellex, Fluoron, Geuder, iOptics, LensAR, Medicem, Novartis, Oculentis, Oertli, Revision Optics, Santen, Staar Surgical, Sifi Medtech, Thea, Topcon, Visufarma, Ziemer

Successful Business of Refractive Surgery in a Private Setting

Detlev R. H. Breyer

Bilder von Fotograf Schadow Arkaden und Oberkassel

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SLIDE 6

What´s The Difference? Private / Chain Business

Private Setting Chain Ownership Always follow the $ trail Surgeon tells the way Economist tells the way Marketing Budget 1 Mio. Euro Several Millions Internet Presence & Branding 1 or 2 cities PremiumEyes, LVC Many cities Optical Express Sales Argument Eminence Method Strategy Premium upper class surgery Family 5 Star Business High volume general population Widespread 4 Star Business Pricing High price Low/Medium price

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SLIDE 7

What Makes A Private Refractive Setting Successful?

  • Surgeon affiliated factors
  • Education and personal surgical experience of a surgeon
  • Scientific work: own publications, peer reviewing, own institute, res. network
  • Awarded Surgeon: accepted by other surgeons
  • Pioneering work: only the best surgeons....
  • Indipendence from method: One surgeon offers ALL! surgical procedures
  • Indipendence from companies: surgeon is choosing the best product
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SLIDE 8

What Makes A Private Refractive Setting Successful?

  • Personal factors
  • Personality / Charisma of the surgeon and team
  • Society network
  • Social engagement: international and at home (Khmer sight, Opera,

Museums,Theater, city, Sport club)

  • International patients / Testimonials
  • Presence in media (TV/Print/Social Media)
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SLIDE 9

What Makes A Private Refractive Setting Successful?

  • Personal factors
  • Personality / Charisma of the surgeon and team
  • Society network
  • Social engagement: international and at home (Khmer sight, Opera,

Museums,Theater, city, Sport club)

  • International patients / Testimonials
  • Presence in media (TV/Print/Social Media)
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SLIDE 10

What Makes A Private Refractive Setting Successful?

  • Personal factors
  • Personality / Charisma of the surgeon and team
  • Society network
  • Social engagement: international and at home (Khmer sight, Opera,

Museums,Theater, city, Sport club)

  • International patients / Testimonials
  • Presence in media (TV/Print/Social Media)
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SLIDE 11

What Makes A Private Refractive Setting Successful?

  • Personal factors
  • Personality / Charisma of the surgeon and team
  • Society network
  • Social engagement: international and at home (Khmer sight, Opera,

Museums,Theater, city, Sport club)

  • International patients / Testimonials
  • Presence in media (TV/Print/Social Media)
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SLIDE 12

What Makes A Private Refractive Setting Successful?

Soft service factors

  • Ambiance of clinic (designer furniture, well known art...)
  • Place of clinic: Real estate: site, site, site
  • Polite & elegant manners: the rot starts at the top
  • More employees (120) than needed - taking a lot of time for patients
  • Service of clinic: own App, private assistant, social media
  • High personal availability: cell phone number and e mail adress
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SLIDE 13

What Makes A Private Refractive Setting Successful?

Soft service factors

  • Ambiance of clinic (designer furniture, well known art...)
  • Place of clinic: Real estate: site, site, site
  • Polite & elegant manners: the rot starts at the top
  • More employees (120) than needed - taking a lot of time for patients
  • Service of clinic: own App, private assistant, social media
  • High personal availability: cell phone number and e mail adress
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SLIDE 14

What Makes A Private Refractive Setting Successful?

Soft service factors

  • Ambiance of clinic (designer furniture, well known art...)
  • Place of clinic: Real estate: site, site, site
  • Polite & elegant manners: the rot starts at the top
  • More employees (120) than needed - taking a lot of time for patients
  • Service of clinic: own App, private assistant, social media
  • High personal availability: cell phone number and e mail adress
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SLIDE 15

What Makes A Private Refractive Setting Successful?

Soft service factors

  • Ambiance of clinic (designer furniture, well known art...)
  • Place of clinic: Real estate: site, site, site
  • Polite & elegant manners: the rot starts at the top
  • More employees (120) than needed - taking a lot of time for patients
  • Service of clinic: own App, private assistant, social media
  • High personal availability: cell phone number and e mail adress
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SLIDE 16

What Makes A Private Refractive Setting Successful?

Hard work & a positive philosophy & creativity for many years Refractive Surgery in a private setting is definetely No quick & easy money You are the conductor of a symphony orchestra, be prepared to work 24/7

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SLIDE 17

VisuMax Mel 80

Never Forget the Fundament of Your Success

Behandlungsmethode Femto-LASIK ReLEx SMILE Laser-Platform CZM Mel 80 CZM VisuMax # Augen 404 1192 M:W [%] 48:52 45:55 MW ± SD Min Median Max MW ± SD Min Median Max p Alter [Jahre] 37 ± 9 18 37 70 34 ± 8 19 33 72 <0,001 Sphäre [dpt]

  • 2,25 ± 2,19
  • 9,25
  • 2,25

5,50

  • 3,94 ± 1,90
  • 9,75
  • 3,75

0,75 <0,001 Zylinder [dpt]

  • 0,90 ± 0,90
  • 4,75
  • 0,75

0,00

  • 0,69 ± 0,68
  • 3,50
  • 0,50

0,00 <0,001 Sphärisches Äquivalent (SÄ) [dpt]

  • 2,70 ± 2,11
  • 10,00
  • 2,50

4,00

  • 4,29 ± 1,90
  • 10,00
  • 4,25
  • 0,13

<0,001 CDVA [logMAR]

  • 0,01 ± 0,07
  • 0,28

0,00 0,36

  • 0,02 ± 0,06
  • 0,20

0,00 0,30 <0,001 UDVA [logMAR] 0,87 ± 0,40

  • 0,18

0,98 1,30 1,10 ± 0,30

  • 0,02

1,30 1,30 <0,001 Zentrale korneale Dicke [µm] 550 ± 30 442 550 632 549 ± 30 469 547 655 0,38 Flap-/Cap-Dicke [µm] 116 ± 9 100 120 160 138 ± 13 110 140 150 <0,001 Ablationons-/Lentikeldicke [µm] 66 ± 24 14 64 151 92 ± 29 36 89 168 <0,001 Zielrefraktion (Laser) [dpt] 0,02 ± 0,43

  • 1,50

0,00 1,00 0,38 ± 0,40

  • 2,00

0,50 1,25 <0,001

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SLIDE 18

0% 25% 50% 75% 100% 3 oder mehr verl. 2 verl. 1 verl. gleich 1 gew. 2 gew. 3 oder mehr gew. Anteil der Augen [%] ∆CDVA [Snellen Lines]

Sicherheit: CDVA(post) - CDVA(prä)

High Safety

Signifikante Unterschiede (p<0,05):

  • SMILE mit leicht besseren (1-2 Buchstaben)

Mittelwerten bei 6M, 1J und 2J  Leichte Vorteile für ReLEx SMILE bei Sicherheit

∆CDVA = CDVA(post) - CDVA(prä) n = #Augen Femto- LASIK ReLEx SMILE p MW ± SD 6 M 54 174 <0,05 0,01 ± 0,06

  • 0,01 ± 0,07

1 J 55 271 <0,05 0,00 ± 0,06

  • 0,05 ± 0,08

2 J 29 89 <0,05 0,01 ± 0,06

  • 0,03 ± 0,07

3 J 34 50 0,16

  • 0,03 ±

0,07

  • 0,01 ± 0,07

5 J 32 26 0,14

  • 0,03 ±

0,07

  • 0,01 ± 0,05

“n verl. (gew.)“: ≥5*n (≤-5*n) Buchstaben Unterschied

Kein Auge mit Verlust von 2 oder mehr Zeilen

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SLIDE 19

High Predictability

  • Leichte Unterkorrektur von ca. 10%
  • Verwende internes Nomogram

während Planungsphase der OP: Erhöhe die Zielkorrektur des SÄ bei myopen Augen um 10%.

Zielkorrektur SÄ = SÄ(Laser-Ziel) – SÄ(prä) Erzielte Korrektur SÄ = SÄ(post) – SÄ(prä)

Lineare Fitgerade: y = m*x + b n = #Augen Femto- LASIK ReLEx SMILE ( m | b ) R² 6 M 54 176 ( 0,96 | -0,20 ) ( 0,88 | 0,06 ) 0,98 0,95

Vorhersagbarkeit

Zielkorrektur SÄ [dpt] Erzielte Korrektur SÄ [dpt]

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SLIDE 20

High Effectiveness

Signifikante (p<0,05 , Wilcoxon Rangsummentest) Unterschiede:

  • SMILE mit leicht besserem UDVA 1 und 2 Jahre nach OP

Betrachte Untergruppe mit: SÄ(Ziel) = 0,0 dpt ± 0,5 dpt

  • Mehr Daten benötigt

monokularer UDVA(post) [logMAR] Median Femto- LASIK ReLEx SMILE p MW ± SD 6 M 0,00 0,00 0,05 0,04 ± 0,12 0,01 ± 0,12 1 J 0,00

  • 0,06

<0,001 0,01 ± 0,10 -0,03 ± 0,1 2 J 0,04

  • 0,04

<0,01 0,08 ± 0,20 -0,03 ± 0,09 3 J

0,03 0,00

0,05 0,06 ± 0,15 0,01 ± 0,13 5 J 0,02 0,00 0,82 0,03 ± 0,10 0,03 ± 0,10

Unkorrigierter Fernvisus

6M 1J 2J 3J 5J 6M 1J 2J 3J 5J LASIK SMILE

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SLIDE 21

Few Induced HOA

  • 2,0
  • 1,5
  • 1,0
  • 0,5

0,0 0,5 1,0 1,5 Astigmatismus (RMS) Total HOA (RMS) Coma (RMS) Sphärische Aberrationen Okulare Aberrationen [µm]

Okulare Aberrationen (6mm)

Lasik präop. (n=255) Lasik post (n=157) Smile präop. (n=631) Smile post (n=524)

Signifikante (p<0.05) Unterschiede:

  • Astigmatismus wird durch Femto-LASIK und ReLEx SMILE reduziert
  • Aberrationen höherer Ordnung postoperativ in beiden Gruppen leicht erhöht

Keine signifikanten Unterschiede zwischen beiden Gruppen Signifikante (p<0.05) Unterschiede:

  • Astigmatismus wird durch Femto-LASIK und ReLEx SMILE reduziert
  • Aberrationen höherer Ordnung postoperativ in beiden Gruppen leicht erhöht

Keine signifikanten Unterschiede zwischen beiden Gruppen

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SLIDE 22
  • Geringe Komplikationsraten

(vergleichbar mit Literaturwerten)

  • Geringe Rate an Nachbehandlungen
  • Vergleichbare Ergebnisse in beiden

Gruppen

Few Complications and Retreatments

Behandlungen Femto- LASIK SMILE

total

404 100% 1197 100%

vollendet

404 100% 1192 99,6%

abgebrochen

0% 5 0,42%

Komplikationen

Vakuumverlust

3 0,74% 6 0,50%

vollendet

3 2

abgebrochen

4 Lentikel nicht separierbar

  • 1

0,08% …

Nachbehandlungen

refraktiv (meist innerhalb 6M) 5 1,24% 4 0,34%

Re-LASIK

5

  • PRK

3

ICL

1 Keratokonus

CXL

1 0,25% 1 0,08%

Sonstiges

Spülung

2 2

Flap-Lifting

6

  • 1 x ICL,

3 x glasses/CL 1 x Trans-PRK

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SLIDE 23

Having All That Said, Never Forget: Nothing is as rewarding as helping and philantropy!

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SLIDE 24

Herzlichen Dank für Ihre Aufmerksamkeit!

Partner of

Thank You Very Much For Your Kind Attention!