Many people wanting to get rid of their contacts and glasses go to a LASIK centre, but are rejected as good candidates. They’re told that they cannot get LASIK or IntraLase because “You’re prescription is too high”, or “You’re cornea is too thin.” This is not really telling the patient the full truth.
What the doctor should have told them is that “the amount of tissue we have to waste cutting the flap, plus the amount of tissue we have to remove to eliminate your prescription, would leave your cornea too thin, and unsafe for LASIK or IntraLase.”
By not cutting a flap, Dr. Chynn is saving 100-150 microns of cornea tissue–which is enough to treat another 10 diopters of prescription. This is why the safe limit for LASIK is about -10, whereas the safe limit for LASEK can be more than -20! So that’s why Dr. Chynn has successfully and safely treated the highest prescription ever lasered in NYC (-22.00)! It’s also why the average prescription treated at Park Avenue LASEK is about -8.00, whereas at every other LASIK centre their average is more like -4.00. Because we are seeing–and treating–many people who were rejected at other centers!
In addition, LASEK avoids the night glare and dry eyes that are sometimes associated with LASIK. Why is this? Again, because LASEK avoids cutting into your eye. In fact, the primary reason that Dr. Chynn switched from performing (thousands) of LASIKs to LASEK is that he himself, has some minor (but bothersome) dry eyes and night glare after his own LASIK.
Night glare after LASIK is caused by your cornea being in 2 pieces forever, since the LASIK flap is cut, lifted up, put back down–and never fully heals. This is why you can enhance a LASIK years later by digging the flap back up–because it never heals. Because of this, after LASIK, light is invariably scattered and refracted by the flap interface. Put another way, the “sandwich” configuration of your cornea is what causes back-scatter of light. This is most noticeable at night–and causes night glare.
Because your cornea is never cut and no flap is made in LASEK, night glare is avoided. In fact, after LASEK, many of our patients say that their night vision is actually better than it was before in glasses or contacts!
Dry eyes after LASIK is also caused by cutting the flap. When this cut is made, most of the corneal nerves are cut–and never grow back (nerves are terminally differentiated tissue, and lack the ability to regrow–which is why if you’re truly paralyzed, it’s unfortunately for life). Your eyes are lubricated by the tear film, which is distributed when you blink. But, there is no “clock” in your brain timing blinks. Instead, you blink when you (subconsciously) sense your eye drying out. This is why you cannot keep your eyes open forever–eventually, this sensation of dryness is so powerful, you cannot avoid blinking.
But what happens when you cut most of your corneal nerves? Published studies have shown that normal people blink every 5-10 seconds–but after LASIK, they blink only every 10-15 seconds. In fact, they’re staring themselves dry without even knowing it!
In contrast, after LASEK, because your cornea and its nerves are never cut, your blink rate afterwards is the same as a normal, unoperated eye–hence, no dry eyes!
You can read the article “Three year longitudinal survey comparing visual outcomes with LASIK and contact lenses” here if you want to know more about dry eye after LASIK.
Dr. Chynn has also eliminated all complications in the operating room by no longer cutting flaps. That’s why we can have the only glass “open OR” in NYC! Do you think we could have people watching on the sidewalk during their lunch, invite companions into the OR, and stream our live LASEK seminars live if there was even a small chance of a major complication? Of course not!
LASEK is newer, safer and all in all a better choice!
Compare it yourself and make your own decision!
Many of our ptients have come in asking what makes our procedure different from a PRK since in both procedures the skin is removed. To put it simply, LASEK is virtually painless compared to a PRK.
There is virtually no pain or discomfort with our LASEK procedure. For patients that elect to have the older PRK surgery, there is immense pain for up to a week or more after surgery. While both procedures don’t cut flaps, in a PRK the skin is sanded it off, which uses a much more abrasive force than the gentler LASEK procedure.
Rather than using a softening solution to allow the skin to loosen, a PRK procedures opt to remove the skin right away. PRK procedures use a small sander to sand the skin off to reach the cornea. The result of this force is that patients experience intense pain and heal slower than with the LASEK procedure.
LASEK is the most advanced version of laser vision correction that is possible with modern medicine today. LASIK is 10x as risky, reduces the structural integrity of your eyes, can worsen glares, halos, and dry eyes, may not get you to your best vision possible. There are also issues of flap complications before and after surgery that may cause a LASIK patient to have poor vision or even go blind after treatment.
The major fear of LASIK after surgery is cutting the corneal flap. There have been many instances of corneal flaps dislodging after trauma to the head, getting poked in the eye etc. Thus, the flap created during LASIK carries two major risks: the risk of a poor flap placement or a disintegrating flap in the OR, and the postoperative risk of having a flap dislodging at any moment.
The end result of all these complications, if they are not properly treated is a corneal transplant and patient will end up being blind. This is why professional sports players, the US military, and airline pilots all opt for LASEK treatments over LASIK
Dr. Chynn use to perform LASIK and had LASIK on himself, but switched over to LASEK (or SafeSight) in 2005 because he realised that it was a much safer procedure with less risk and complications than a LASIK.
LASIK Procedure: This video shows a LASIK procedure doing an enhancement (LASIK over a LASIK). The doctor attempts to flip the flap up to perform the procedure, but the flap disintegrates as soon as the doctor begins the operation.
Patients are often confused about all the terminology regarding LASIK and LASEK. Basically, the former is cutting, and the latter is non-cutting. A totally different issue is custom vs. standard. For clarity, here are all the terms that all indicate custom, meaning these terms are all synonyms: custom, wavefront, CustomVue, Hi-Def. The non-custom, non-standard type of treatment is usually referred to as “standard” (because non-custom or non-hi-def sounds bad to the customer). You should be very clear about what is the difference between these two options.
Standard means the laser is correcting your prescription to the same degree of precision as glasses or contacts–namely, in increments of +/- 0.25 diopters. For example, your contact or eyeglass prescription is always given in quarter diopter increments, like -3.00 or -3.25, there is nothing in-between. If you’re observant and have looked at your prescription over the years, you’ve already noticed this, so if your optometrist gives you a prescription for new glasses that were -3.18, you would say something like, “Wow, I guess you guys have figured out how to grind glasses more precisely these days–that’s really cool!”
Unfortunately, that’s also not true. It’s basically impossible to make eyeglasses or contacts that accurate. More unfortunately, these days some contact and lens manufacturers are trying to market their products as “digital” or “custom” or “wavefront.” This is impossible, as when you look out of contacts or glasses, the contacts move in your eye, and your eye looks out of different parts of your glasses. Therefore, even if the lens is “custom” you will wind up looking out of the wrong part of the lens, so you will not see any benefit from your “digital” lenses (that you paid more for).
In contrast, with LASEK, you can get a correction that is actually the precise one you need–not some average to the nearest quarter. Moreover, with the VISX S4 IR system, you will actually have 50 different prescriptions lasered onto your cornea accurate to the nearest hundredth! This is why these days, after our Hi-Def SafeSight procedure, the majority of our patients are actually seeing better without glasses and contacts than they did with them–because it’s just a much more accurate prescription.
Furthermore, when Dr. Chynn was performing CustomVue LASIK, he wasn’t getting nearly this many people better than 20/20. The reason is that the CustomVue WaveScan is obtained before the cut in LASIK is made—yet many published studies have reported that cutting a flap distorts the WaveScan. Therefore, the surgeon winds up using a WaveScan to laser the cornea that is not 100% accurate–because it was obtained before the flap was made.
This is why when Dr. Chynn was performing CustomVue LASIK, he was only getting about 10-20% of his patients seeing better than 20/20. Once he switched to LASEK, he immediately started getting 30-40% of his patients better than 20/20. Now, it’s more like 50-60%. The reason his results are better now, with the same laser, is because by not cutting a flap, the WaveFront scan is 100% accurate, and not distorted by the flap, so the treatment is exactly what is needed, rather than what would have been needed if a flap hadn’t been cut (but was) in LASIK.
We understand that this explanation is somewhat complicated, so invite you to call our centre, make an appointment for a free consultation, and then have Dr. Chynn or one of his 4 doctors (all true MD surgeons, not ODs or optometrists or “techs”) explain this in more detail.