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

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 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

Who am I? to tell YOU this… Dr. rer. nat. Dr. rer. nat. Dr. med. Dr. med. Dr. med. Philipp Hagen Andreas Fricke Detlev Breyer Hakan Kaymak Karsten Klabe Prof. Dr. med. Dr. med. Florian Gerd U. Auffarth T. A. Kretz

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

How Are Other Successful Private Refractive Settings? • International leading refractive surgeon and successful entrepreneur • Dan Reinstein

Successful Business of Refractive Surgery in a Private Setting Detlev R. H. Breyer Bilder von Fotograf Schadow Arkaden und Oberkassel 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

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

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

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)

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)

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)

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)

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

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

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

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

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

Never Forget the Fundament of Your Success Behandlungsmethode Femto-LASIK ReLEx SMILE VisuMax Mel 80 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) -10,00 -2,50 4,00 -10,00 -4,25 -0,13 <0,001 -2,70 ± 2,11 -4,29 ± 1,90 [dpt] 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] 14 64 151 36 89 168 <0,001 66 ± 24 92 ± 29 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

High Safety Sicherheit: CDVA(post) - CDVA(prä) ∆CDVA = CDVA( post) - CDVA(prä) 100% n = #Augen Femto- ReLEx SMILE p LASIK MW ± SD 54 174 6 M <0,05 0,01 ± 0,06 -0,01 ± 0,07 75% 55 271 1 J <0,05 0,00 ± 0,06 -0,05 ± 0,08 Anteil der Augen [%] 29 89 2 J <0,05 0,01 ± 0,06 -0,03 ± 0,07 34 50 50% 3 J 0,16 -0,03 ± -0,01 ± 0,07 0,07 32 26 Kein Auge 5 J 0,14 -0,03 ± mit Verlust -0,01 ± 0,05 0,07 von 2 oder 25% mehr Zeilen Signifikante Unterschiede (p<0,05): • SMILE mit leicht besseren (1-2 Buchstaben) 0% Mittelwerten bei 6M, 1J und 2J 2 verl. 1 verl. mehr verl. gleich 1 gew. 2 gew. mehr gew. 3 oder 3 oder  Leichte Vorteile für ReLEx SMILE bei Sicherheit ∆CDVA [Snellen Lines] “n verl. ( gew .)“: ≥5*n (≤ -5*n) Buchstaben Unterschied

High Predictability Zielkorrektur SÄ = SÄ(Laser-Ziel) – SÄ(prä) Erzielte Korrektur SÄ = SÄ(post) – SÄ(prä) Lineare Fitgerade: y = m*x + b Vorhersagbarkeit n = #Augen Femto- ReLEx ( m | b ) LASIK SMILE R² 54 176 6 M ( 0,96 | -0,20 ) ( 0,88 | 0,06 ) Erzielte Korrektur SÄ [dpt] 0,98 0,95 • Leichte Unterkorrektur von ca. 10%  Verwende internes Nomogram während Planungsphase der OP: Erhöhe die Zielkorrektur des SÄ bei myopen Augen um 10%. Zielkorrektur SÄ [dpt]

High Effectiveness Unkorrigierter Fernvisus Betrachte Untergruppe mit: SÄ(Ziel) = 0,0 dpt ± 0,5 dpt monokularer UDVA(post) [logMAR] Median Femto- ReLEx p LASIK SMILE MW ± SD 0,00 0,00 0,05 6 M 0,04 ± 0,12 0,01 ± 0,12 0,00 -0,06 <0,001 1 J 0,01 ± 0,10 -0,03 ± 0,1 0,04 -0,04 <0,01 2 J 0,08 ± 0,20 -0,03 ± 0,09 0,03 0,00 0,05 3 J 0,06 ± 0,15 0,01 ± 0,13 0,02 0,00 0,82 5 J 0,03 ± 0,10 0,03 ± 0,10 6M 1J 2J 3J 5J 6M 1J 2J 3J 5J LASIK SMILE  Mehr Daten benötigt Signifikante (p<0,05 , Wilcoxon Rangsummentest) Unterschiede: SMILE mit leicht besserem UDVA 1 und 2 Jahre nach OP •