Profiles in Practice Success
Wave of the Future
This surgeon credits his prosperity to one of today's excimer lasers.

THE PRACTICE: Ronald R. Krueger, M.D., is medical director of the refractive surgery department at the Cole Eye Institute, an affiliate of the Cleveland Clinic Foundation, which is located in Cleveland, Ohio. This past July, U.S. News & World Report named the Cleveland Clinic Foundation one of the 10 best hospitals in the country.

PRACTICE SUMMARY: Dr. Krueger oversees the department of refractive surgery, which includes four ophthalmologists, three optometrists, one registered nurse, three technicians, two front-office employees and one secretary.

SURGICAL FOCUS: Of the procedures Dr. Krueger performs, 95% are refractive. Last year, the department of refractive surgery treated 2,400 eyes; Dr. Krueger treated 1,500 of those eyes. "This year," he says, "I expect my caseload to continue to grow. In my market, patients are seeking excellence over price."

PREFERRED INSTRUMENTS: Dr. Krueger's preferred microkeratomes include the Moria Carriazo-Barraquer and the Hansatome, which are used equally in the surgery department, according to Dr. Krueger.

He also uses LADARVision from Alcon Summit Autonomous. Dr. Krueger, who is a consultant for Alcon Summit Autonomous, says he's especially impressed by LADARVision's scanning and tracking technology, and the way the pulses overlap to produce a smooth postoperative corneal surface.

"We use this technology because of its flying-spot design and sophisticated tracking system. LADARVision gives me excellent results for all refractive indications," he says. "I believe we're going to see a greater movement toward the use of the flying-spot laser."

PREFERRED MEDICATIONS: "Post-op laser-assisted in situ keratomileusis (LASIK) drops include Ciloxan and Flarex because of the broad antimicrobial coverage and strong anti-inflammatory action."

GROWTH AREAS: "Refractive surgery has been the reason for our growth. We've strived to market our practice as a premium provider of LASIK, and haven't changed our pricing structure."

SLOW SPOTS: "Because of the growth in refractive surgery, we haven't experienced any slow spots. In fact, we're starting to see fewer cases of enhancements, due to the LADARVision laser."

EXTRACURRICULAR ACTIVITIES: Dr. Krueger is co-editor of the textbook Customized Corneal Ablations: The Quest for Super Vision, due out this month. He's also co-chairman of the Second International Congress of Wavefront Sensing and Aberration-Free Refractive Correction.

MANAGEMENT PHILOSOPHY: "I strive for excellence in service when dealing with my patients, both pre- and postoperatively. My staff helps me do this by sharing in the responsibility.

"Using my leadership skills, I delegate and empower, so my staff can act on their own initiative. I see myself as a delegator, not a dictator."