Effective communication plays a vital role in the field of refractive surgery, wherein precise terminology is crucial for conveying complex procedures and ensuring clear understanding between medical professionals and patients. In recent years, there has been a growing recognition of the need for standardized language to improve communication with and reduce ambiguity for patients. One approach that has gained traction is the use of specific terminology as opposed to colloquial or trademarked/industry terms. This shift to a standardized language offers a concise and consistent means of conveying important information to patients everywhere.
In 2022, the Refractive Surgical Terminology Committe made up of Refractive Surgery Alliance members from America, Europe, and Asia-Pacific regions, came together to develop and propose terminology to be used by the wider ophthalmic community. Moreover, this committee had a goal to ensure that these terms not only clearly conveyed the appropriate messaging but also were sensitive to translation, allowing for consistency across global cooperation.
LENS REPLACEMENT
In considering a standardized terminology for lens replacement procedures, the term lens replacement (LR) stands out as the most appropriate choice. This term is simple, yet it elegantly encompasses the essence of the procedure: the replacement of a dysfunctional lens with a custom-fit replacement.
Using the term dysfunctional lens in consultation with patients effectively communicates the need for the procedure, while customized lens replacement accurately describes the solution. The term lens replacement allows for flexibility in the language used by clinicians in different contexts and takes into consideration various language considerations and subtle differences in counseling techniques.
Furthermore, the term lens replacement is already widely adopted by patients, indicating a level of acceptance and an ease of understanding. The use of replacement as opposed to exchange also aligns with the terminology used in other medical specialties and better conveys the idea of a replacement of an old lens with a new one.
Alternative terms such as custom lens replacement or custom lens exchange (CLR/CLE), dysfunctional lens replacement or dysfunctional lens exchange (DLR/DLE), refractive lens exchange (RLE), clear lens exchange or clear lens enhancement (CLE), laser lens upgrade (LLU), therapeutic lens exchange (TLE), lens implant focusing enhancement (LIFE), and permanent prescription lens replacement (PPLR) were also considered. However, they were ultimately rejected as they fail to convey the level of simplicity and patient understanding conveyed by lens replacement.
Overall, the use of the term lens replacement in the refractive surgery industry promotes clarity and understanding for both patients and colleagues in ophthalmology and optometry.
LASER-ASSISTED LENTICULE EXTRACTION
Laser-assisted lenticule extraction (LALEX) is a term that encompasses all lenticule extraction procedures, including small-incision lenticule extraction (SMILE), refractive lenticule extraction (ReLEX), cornea lenticule extraction for advanced refractive correction (CLEAR), and smooth incision lenticule keratomileusis (SILK). The use of the term laser-assisted lenticule extraction does not give preference to one laser vision correction procedure over another, and it is phonetically similar to LASIK, allowing for both procedures to be discussed cohesively.
One key advantage of using the term LALEX is that it avoids any technical jargon that may not be easily understood by patients. Words such as femtosecond, intrastromal, and corneal can be confusing for patients; LALEX provides a simpler and more easily understood alternative. It should be noted that the term LALEX has been adopted by our German colleagues, and we recognize and appreciate their contribution in arriving at this term.
Other terms that were considered but ultimately rejected include small-incision LASIK (SI-LASIK), minimally invasive LASIK (MI-LASIK), keyhole LASIK, pocket LASIK, endo-LASIK, femtosecond lenticular corneal shaping (FLCS), and femtosecond laser intrastromal tissue excision (FLITE). These terms were rejected as they did not effectively encompass all lenticule extraction procedures or did not have the desired level of simplicity and ease of understanding for patients.
SURGICAL TEMPORARY OCULAR DISCOMFORT SYNDROME
Surgical temporary ocular discomfort syndrome (STODS) is a term used to describe the temporary discomfort experienced by patients after vision correction procedures. The priority in the naming of this syndrome is to convey that the discomfort is not unique; this sensation is temporary and a normal part of healing process. This is important to validate the experiences of patients and to avoid any unintended manipulation.
The term surgical temporary ocular discomfort syndrome also encompasses the neurologic deviation that can occur after all types of vision correction procedures, and it is important to note that this is not a dry eye condition. The emphasis on the temporary nature of the discomfort is important medicolegally as well.
Alternative terms considered include transient innervation deficit after eye surgery (TIDES) and ocular surface surgical recovery (OSSR). These were ultimately rejected as they did not convey the temporary and healing nature of the discomfort experienced.
SUMMARY
By adopting industry-independent terminology, the field of refractive surgery can achieve a cohesive and universally understood language that transcends geographic boundaries and diverse medical practices. This consistency not only promotes effective communication between medical professionals but also enhances patient care by reducing the potential for misinterpretation or confusion.
