Learn About LASIK, EVO ICL and CLR: November 15

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ICL. And they’re just two of our many patients. And maybe you heard some things on the radio that got you to come to this webinar or you spoke to a friend.

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who told you about it. But regardless, what we are doing

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is what we are doing is

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going to share, and I’m going to pause for a moment because I just got a text. Craig, can you see the screen with our patient UL on it?

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I can see it.

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Okay, very good. I just wanted to clarify that, that everyone else can as well.

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But here’s an everyday patient, Yoel. He’s a very active guy. He’s an engineer.

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You can see him on the water. He’s about to go up in the air. He’s climbing mountains. And part of what modern vision correction does is allow people to live their lives more fully. It’s very gratifying for us to be able to be in the position

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to provide that. And here’s a gentleman whose wife is just coming out of having CLR.

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So Christine, how was that for you?

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very, very easily simple, felt nothing just a great process. In the middle here. Come on. All right. Awesome. Thank you for letting us take care of you, Christine. We’re going to see you tomorrow morning. Okay. Absolutely, Doug. Thank you. Bye, brother.

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It’s really that little video clip just helps describe the joy that we feel

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Bringing this to the lives of our patients.

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Today, we’re going to describe what modern vision correction is all about, our different procedures. We’re going to help you understand

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whether or not you might be a candidate for one of the procedures and

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which procedure might be best. They’ll start to steer your thinking in that direction, though we don’t really know until you come in for a consultation and an exam.

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And we’ll cover things like side effects and recovery and

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cost and whether or not insurance covers it. So those are some of the things that we’re going to talk about. But first, I want to just introduce

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To you, Dr. Craig Bendy. Dr. Bindi is…

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The medical director of the Laser Eye Center and longtime eye surgeon, Dr. Bindi, thanks so much for taking time

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First.

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In between morning and afternoon surgery and clinic. And I’d just like to start with you. Dr. Benny, what is the problem we’re trying to solve?

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Well, I mean, people come to see us and they don’t like wearing glasses or contacts. So in

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In 2024, it’s really not too much to ask to be able to drive to a restaurant.

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And when you get to the restaurant, you could read the menu.

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No glasses, no contacts, or just things like being able to sit on your couch and watch TV and also look at your cell phone.

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Things that people want to be able to do to do the things they like to do.

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Or some people, they just want to be able to wake up in the morning and not reach for their glasses on their nightstand. They just want to wake up and see.

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So I guess I say these are the problems that we fix. And then this topic today, we’re talking about

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modern vision correction. So I will talk about that and

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And maybe for starters, maybe some people have heard of LASIK, but they might not know what the term

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modern vision correction is so

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Modern vision correction, it really just refers to a group of different procedures so people can

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Wake up and see and do the things they want to do where they don’t need to wear glasses or contacts.

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Some of our patients, they might have been wearing glasses since they were in grade school.

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And it’s always been a part of their lives and other people.

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They’ve seen great for most of their lives. And then as they move through the 40s and 50s, maybe they notice their near vision got worse.

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And that’s where readers and bifocals and progressive lenses start to come into play.

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And so modern vision correction is really a group of different procedures, laser treatments and lens treatments.

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to put light and focus so people can see and they don’t need to wear glasses or contacts.

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That’s great. And Dr. Bindi, if you could just, we brought up an anatomy slide here. If you could just orient people

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to the different eye structures and what we do in what normal abnormal

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Sure. Yeah.

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And before you start, let me just let everyone know also that we have Renee with us. You don’t see her on camera right now.

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But she is helping answer questions. So on your Zoom screen, you will see something called Q&A. And we ask you to use that. If you have a question you want to ask, go to the Q&A button, type it in, and we will answer it. We’ll try to answer it live if we don’t have enough time

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Believe me, everyone is going to get a response to their question as long as we know who you are. If it’s anonymous, you need to type in your name and email in the question so we can get back to you.

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But with that, Dr. Vendi, please go ahead.

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All right. So what you can see on the left part of the eye diagram, the cornea is the very front part of the eye so

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Every time we see something late enters first through the cornea.

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Then it passed through the lens, that structure in the middle. Sharif, I don’t know if you have a cursor, but you can see the lens right there.

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And then life should be focused on the retina.

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Most people have some degree of a focusing issue where it might be blurry at distance or blurry up close.

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And that’s just caused when light is not perfectly focused on the retina.

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And so we can correct focusing problems typically with glasses or contacts or how it’s usually been done.

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In fact, we refer to vision correction 1.0 as just simply wearing glasses or contacts.

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And then over the years in the later 90s, early 2000s.

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Laser procedures were approved by the FDA.

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And that’s where we could do a laser treatment on the front of the eye of the cornea. So instead of wearing glasses or contacts.

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The earliest versions of LASIK

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could fix focusing issues. And in fact, I had my LASIK done about 25 years ago.

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And so vision correction 2.0 is kind of the earliest versions of vision correction.

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kind of the earliest form of LASIK and then

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Nowadays, we refer to vision correction 3.0

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And it’s the most highly evolved versions of laser and lens treatments. So today we’ll be talking about

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Modern LASIK, Epilasic, and Smile LASIK.

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As well as other procedures like the Evo ICL and CLR custom lens replacement.

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And these are all these groups of procedures that help people do what they want to do so they don’t have to wear glasses or contacts.

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There you go. And Dr. Vinny, why don’t we just jump right in and

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just talk about what happens in the laser room. And you’ll see that green blinking light in a second.

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Okay, well, sure. So, well, the picture on the left, when we do LASIK, that’s an eczema laser.

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And so what a patient would do is before they walked in the room, they would get numbing eye drop

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They would get a pill of Valium because generally people get a little anxious for things like this.

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And I guess my point there is we don’t need to do IVs. There are no injections. There’s no blades, there’s no blood. These are laser treatments.

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Numbing eye drops and then a pill of allium and then treatment with laser.

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So people walk into the room, they lay on that bed on the picture on the left, they’re on their back.

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their heads in the headrests and when they look up

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what a patient can see from a patient’s perspective is what you see on the right.

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And so right there where you see the green blinking light, that’s the exact image of what a patient would see during their laser treatment.

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So they’re able to see a green light and then the laser itself is invisible.

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But most treatments take about 10 to 15 seconds. And while a patient looks at the green light, the laser can treat the prescription, nearsightedness and astigmatism.

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Invariably, when people look at that picture, they wonder.

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They’ll say things like, wait a minute, what would happen if I blink or what would happen

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If my head moves or my eyes move or I cough.

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And so these lasers are able to track eye movements. They can actually move with you a thousand times per second if you move.

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And there’s a little instrument that keeps you from blinking. So if someone squeezes their eyelid shut or they move or look away, we’ve gotten around those things.

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And then after, if someone is LASIK or smile, the recovery is quick. It’s an overnight recovery.

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And so people do their surgery, they have to arrange for someone else to drive them home.

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It’s blurry for about five or six hours, but by the next day, people can see clear and they’re comfortable and they can go back to normal activities. So they generally do their surgery

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maybe on a Thursday or Friday, they’re usually back at work.

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Will they go back to work on Monday, some work the next day.

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Great. And Dr. Bendy, just one more question on LASIK. You talked about modern LASIK and the three forms of it. Do you want us to do a quick summary?

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Between the three?

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Yeah. So most people have heard of the word LASIK as kind of the term people use conversationally. They’ll say, I had LASIK three years ago, but

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LASIK is actually the umbrella term. And then underneath that umbrella term.

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the three versions of Lacey include all laser LASIK,

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Epilasic, also known as PRK, and Smile LASIK.

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And they’re all laser treatments. And the way we can tell which one to pick, it really depends on a patient’s individual measurements.

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So the, I mean, the results are the same, they cost the same, patient satisfaction is the same.

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But there are clinical measurements that we take to find out which one’s going to work better.

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For example, if somebody’s farsighted.

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One works better than the other two. So if I meet a farsighted patient, I might make a different suggestion than a different patient who was nearsighted or

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If somebody has a lot of astigmatism, a different one might work better. Larger corrections, smaller correction.

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Some people have thin corneas and so it really depends on someone’s unique measurements. And then we just say which one’s going to be the best.

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And we’ll get into the measurement process later and show the level of detail that you are going to as surgeons.

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to make sure that we get the right information coming in. I want to toss it over now to Dr. Koshek.

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Dr. Sudkoshek, welcome. So glad you were able to get you during the break as well. And we want you, Dr. Coach, to talk about another procedure that we do.

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The Evo ICL, which is getting much more widely known now. And if you would just describe what that is and how it’s different from LASIK and why maybe some patients

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might be more appropriate to have this than the LASIK procedure.

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Yeah, thank you so much, Sharif and Dr. Bindi. Very excited to be here. The Evo ICL is a great surgical option to correct patients prescriptions and get them out of glasses and contact lenses. It stands for insertable contact lens, implantable columnar lens. These are different kind of terminology for this type of technology. And the way it works, and I like to simplify things, is

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Patients are very familiar with contact lenses. So you can kind of imagine a contact lens. It’s very similar to that, except instead of you manually putting it on your eye and taking it off at the end of the day.

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We actually put it inside of your eye and it stays there. It doesn’t need to be removed by you. You don’t have to alter it in any way. And you cannot feel it at all or see it.

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So it is something that will stay in your eye, correct your vision, and you won’t even need to think about it. Just go on and live your life and see really well. In terms of actually determining a good selection for a patient to have the Evo ICL,

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Like Dr. Bindi mentioned, we look carefully at the measurements, we look at your prescription, your eye anatomy.

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And through looking at all those different factors, we’re able to determine maybe you have

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a slightly thinner cornea, or maybe you have a very high prescription. And in those cases, it might be preferable to actually do the Evo ICL, which will give you that great

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uncorrected vision where you’re not using glasses and contacts and we’re not altering that cornea, that clear windshield of your eye.

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And so that’s how we determine we kind of go through a comprehensive eye exam and make sure that you’re an excellent candidate. And we pair you with the best type of technology for your eye

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your anatomy.

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So we’ve now reviewed four of the five main major modern vision correction procedures and

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Dr. Ling was able to join us now. Good to see you, Dr. Ling. Looks like you’ve just finished up your morning

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surgical cases, and we’re going to jump right in to talking about the lens.

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And now, and would you please just kind of start by talking about what happens to this lens as we age?

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I’ll show the fluctuation in a moment.

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Hi, everyone. I’m Dr. Joseph Lang. Thanks for joining us. A little bit tardy due to the procedure.

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I just finished today.

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I’m very excited to teach you guys about what we do here. So here, Sharif.

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has pulled up an anatomy of the eye. And this is a very important cross-section we’re showing because it shows you the natural crystalline lens

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that we all have. And this lens allows refocusing of our vision

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Which most of us took for granted when we were young. When we’re young, whether we need glasses or not.

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We can simply just wear one pair or no glasses and be able to see far and near.

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And what Sharia is doing is showing that lens contracting, expanding

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And that is what allows for our focus to change when we hold something up close. It happens instantaneously.

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And it’s very nice and unfortunately doesn’t last forever. So typically in our 40s is when that lens starts to noticeably

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degenerates. We call it dysfunctional lens syndrome and we all go through it.

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It’s not something that happens only to some people. We all grow through this age-related phenomenon.

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This lens will harden up

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They’ll lose its focusing property and we start to pick up those over-the-counter reading glasses or we start to

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Use progressives, bifocals.

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Well, we do monovision with our contact lenses to compensate for that natural loss of

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focusing. And beyond that, that lens continues to worsen. So your prescription will change year over year increasingly.

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As well as the quality of vision through that lens degrades. On the right hand side here, you see an aging lens that’s starting to turn yellow.

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That’s progression from dysfunctional lens into a cataract, which again is age-related, happens to all of us.

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Lights will hit this cloudy lens now and start to scatter.

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And I think you got muted there.

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And this condition of cataract doesn’t happen overnight against a very

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Dr. Lange it for a second. You need to unmute. There you go.

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So most people go through this process in their mid to late 50s, noticeably, and it just continued to worsen. At some point, it’ll become medically necessary for someone to go through a cataract surgery procedure.

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to get this treated and you probably have most of you probably heard of cataract surgery

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And custom lens replacement is a procedure to prevent this from happening all the while correcting

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for the need of age-related glasses or just an inborn need for glasses that you may have your entire life.

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We can revamp the vision by doing a lens replacement and preventing the worsening of your vision.

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And Dr. Lang and to all the surgeons, I want to open it up now for some questions because the questions are coming in. Thank you for renee.

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Thank you, people, for asking questions. That’s awesome. And thank you, Renee, for answering them. But some that I’m seeing here, and I want to ask specifically about CLR. If someone has CLR,

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Will they need to have cataract surgery down the road?

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So for someone that had cataract surgery, that essentially took place of COR.

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Custom lens replacement and cataract surgery share a lot in common.

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Both are essentially lens replacement.

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The customized part is very specific to CLR and cataract surgery and many times are very generic.

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And basic in its form.

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So it’s all about the lens you put in. So if you put in a customized lens, you’re going to get a more refractive outcome

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Meaning that you’re going to minimize your need for glasses. So if you had cataract surgery, that road has already been trodden.

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Now, there are still options to adjust the vision via techniques such as LASIK.

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And we can look at options for you, but CLR typically isn’t another option we were looking

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If you already had cataract surgery.

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Thank you.

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And also, I would say if somebody has had CLR, they would never go on to develop a cataract.

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So once the lens is fixed.

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The lens implant is an inanimate object, so it never goes on to age or change and turn into a cataract.

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So if somebody does CLR and let’s say they’re in their 60s

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That lens is a permanent fix. It never goes on to develop into a cataract.

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I know when Dr. Lang and Dr. Koshek’s peak of CLR with their patients.

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The way we describe it is it’s a way to fix distance vision so people can see clear far away.

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It’s a way to make it easier to see up close. You don’t need readers and bifocals.

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And then you never develop a cataract after CLR because the lens has been fixed.

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And the lens implant is an inanimate object. It doesn’t age or change into a cataract, and that’s why we describe it more as a permanent way to stabilize the optics of the eye.

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It’s very good. Dr. Bendy, if you did LASIK on someone

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10 years ago, 20 years ago, because you’ve been doing this a long time.

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Could they come in now, if they’re experiencing these changes, these lens changes that Dr. Lang talked about, could they come in now

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Even though they had LASIK in the past and have CLR with either Dr. Lang or Dr. Kosick.

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Good question. And that is a common scenario. And even some of the people who are listening today on this webinar.

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They are people that I did LASIK on 15 or 20 years ago.

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And so LASIK doesn’t stop the aging process.

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LASIK does one thing very well. It treats all the nearsightedness and astigmatism the prescription.

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to give people very good vision.

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But then as people get older, the lens will gradually change as people move through their 40s, 50s, and 60s.

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And then when the lens starts to change significantly, that’s when we say, well, and sometimes we might do a laser treatment to fine tune it if it’s not too far

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progressed. But sometimes it makes sense to do CLR as a different option.

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It really depends on the measurements, but sometimes we’ll do a laser treatment to fine tune it. If the lens looks like it’s still in good shape.

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or if it’s progress, we tend to think about doing CLR as a better option.

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And Dr. Coley.

00:19:30.000 –> 00:19:32.000
But you can definitely do CLR if you’ve had LASIK in the past, yeah.

00:19:32.000 –> 00:19:36.000
Thank you. Dr. Koshek, I’m getting people asking questions around, does it hurt?

00:19:36.000 –> 00:19:41.000
And if you just talk about that across all our procedures, am I going to feel any pain during this?

00:19:41.000 –> 00:19:51.000
Yeah, I think this is a common question that we face as surgeons. And ideally, the way we kind of explain it is whether you’re getting laser vision correction with

00:19:51.000 –> 00:19:56.000
LASIK or Epilasic or Smile LASIK, or you’re getting Evo ICL,

00:19:56.000 –> 00:20:15.000
or you’re getting a custom lens replacement, the experience on your end as a patient is going to be identical. You’re not going to feel pain. You’re going to be very comfortable. And we kind of work with you, make sure that we give you some oral Valium to make sure you’re relaxed. We numb up the eye really well and you don’t feel pain. And across the spectrum in all of these procedures.

00:20:15.000 –> 00:20:29.000
So I think that’s something that’s really reassuring for patients to hear and understand that they’re taken care of really well. We’re addressing all these things up front and making sure they’re comfortable by the time they’re getting ready to lie down for the procedure.

00:20:29.000 –> 00:20:40.000
Great. And Dr. Ling, I just wanted you to start talking about what it’s like when people have the procedure. Kind of give them a sense of that while I bring up the next slide.

00:20:40.000 –> 00:20:48.000
So custom lens replacement is a outpatient procedure. So it’s a routine procedure. Now we have honed it and developed it

00:20:48.000 –> 00:20:54.000
off the cataract surgery platform that we’ve been using for the past 60 years.

00:20:54.000 –> 00:21:00.000
And to a degree now, it’s a 10 minute procedure for each eye. We do both eyes sequentially on the same day.

00:21:00.000 –> 00:21:11.000
It’s a very, very convenient and comfortable process. You’re with us, you’re coming to our office. We have office-based surgery suite here available, as you see here.

00:21:11.000 –> 00:21:19.000
on the slide. So it’s all familiar faces, you know, and having met all the staff here through your consultation.

00:21:19.000 –> 00:21:24.000
You’ll feel very familiar. It’s not like a new place. We don’t need to administer IV.

00:21:24.000 –> 00:21:34.000
procedure is done under topical anesthesia, meaning that the eye drop itself will provide more than ample amount of anesthetic, complete

00:21:34.000 –> 00:21:36.000
no sensation, no pain.

00:21:36.000 –> 00:21:38.000
with the eyes during the procedure. So comfortable.

00:21:38.000 –> 00:21:42.000
And you’re just looking towards a bright microscope life for that 10 minute duration.

00:21:42.000 –> 00:21:51.000
Many patients and I have a conversation during that 10 minute process and they’re just admiring the lights saying that it reminds me of some concert they went to while listening to music.

00:21:51.000 –> 00:21:57.000
So it’s all very much a comfortable process. You may feel eye drops of pressure here and there.

00:21:57.000 –> 00:22:03.000
But nothing that is unpleasant or unbearable.

00:22:03.000 –> 00:22:10.000
And most patients, after they’re done, it’s dramatically easier than I had expected because we understand, you know, procedures.

00:22:10.000 –> 00:22:13.000
around or in the eyes can be a little bit scary.

00:22:13.000 –> 00:22:19.000
in mindset. We do offer Valium as well, and we encourage it for those who

00:22:19.000 –> 00:22:25.000
can tolerate it and that kind of helps relax each individual and get a good nap in after the procedure.

00:22:25.000 –> 00:22:26.000
Wonderful. And Dr. Coach.

00:22:26.000 –> 00:22:35.000
And I know Dr. Koshek and Dr. Ling have talked about this, but for people who are familiar with someone who’s had LASIK in the past, if you listen to the way they describe it.

00:22:35.000 –> 00:22:40.000
They’ll generally say when they do LASIK, the procedure takes about 15 to 20 minutes. It doesn’t hurt.

00:22:40.000 –> 00:22:46.000
And then it heals up overnight. And if someone does evo ICL or CLR, just to kind of think of LASIK as a reference point.

00:22:46.000 –> 00:22:53.000
People use the exact same verbiage if they do Evo, ICL, or CLR. It takes about 15 to 20 minutes.

00:22:53.000 –> 00:22:59.000
It doesn’t hurt and the healing is within the first day or so. So it’s pretty similar to that to give you a reference point.

00:22:59.000 –> 00:23:07.000
Very good. I want to just go back one slide and just show these lenses. And Dr. Koshek, would you just describe what’s on the screen here?

00:23:07.000 –> 00:23:14.000
Sure. Yeah. So these are all various types of intraocular lenses. So when we are discussing CLR,

00:23:14.000 –> 00:23:38.000
We are replacing that dysfunctional lens that Dr. Ling was mentioning. And in its place, we’re going to put in an artificial lens. And the artificial lens has many benefits. It doesn’t undergo a degenerative process like your natural lens did. So your prescription is stable after having surgery. And this intraocular lens, we have a variety of options at our

00:23:38.000 –> 00:23:44.000
disposal. So we can really customize our treatment to the patient based on

00:23:44.000 –> 00:24:09.000
our conversation with you will figure out what your hobbies are, what your interests are, what you really enjoy doing day to day. And we’re going to give you a customized treatment with a customized lens that will fit your lifestyle. So just what you’re seeing on your screen are just various different options for these type of lenses. And I kind of would say that we don’t employ a one size fits all approach. We are definitely

00:24:09.000 –> 00:24:20.000
picking the intraocular lens based on our surgical expertise and skill, but also pairing it with your goals and your desires to give you the best vision and the most satisfaction.

00:24:20.000 –> 00:24:28.000
Great. And then immediately after the procedure, Dr. Bindi, just describe what it’s like

00:24:28.000 –> 00:24:31.000
You know, for patients right when they finish.

00:24:31.000 –> 00:24:40.000
you know, usually people are relieved more than anything else. Like Dr. Ling was saying, people come in anxious and the Valium helps, but I think they’re just happy that they’re done.

00:24:40.000 –> 00:24:47.000
People can see drastically better as they leave the room. So they walk in blurry, they walk out seeing better.

00:24:47.000 –> 00:24:54.000
We still tell people, think of the day of the surgery, that first day or two, you’re kind of going through most of the healing that first day or so.

00:24:54.000 –> 00:24:59.000
So we do have people arrange for a ride home. They go home and take a nap and sleep off the

00:24:59.000 –> 00:25:06.000
And just Lalo that first evening. And then by the next day, people are comfortable. We see them the next day just to

00:25:06.000 –> 00:25:09.000
track people’s progress and make sure they’re coming along nicely.

00:25:09.000 –> 00:25:15.000
But yeah, it’s pretty much within a day or so, people feel like they’re back on their feet, ready to go.

00:25:15.000 –> 00:25:20.000
Well, let’s now take that because we know it’s so wonderful, but I’d like each of you to comment a little bit on

00:25:20.000 –> 00:25:24.000
You know, what are the common side effects? What could happen?

00:25:24.000 –> 00:25:28.000
to a patient here. And I think each of you commenting on this would be good. And then we’re going to

00:25:28.000 –> 00:25:31.000
talk to an actual, we’re going to hear from a CLR patient. Go ahead, please.

00:25:31.000 –> 00:25:37.000
Well, I can start off just with laser vision correction. That’s my area of expertise and Dr. Kushik and Ling, they have added

00:25:37.000 –> 00:25:40.000
added expertise in these lens treatments and

00:25:40.000 –> 00:25:49.000
With LASIK, a couple of things. So first of all, not doing a procedure on someone who’s not a good candidate is by far the most practical way to avoid

00:25:49.000 –> 00:25:57.000
the LASIK associated problem. So that’s where people need to come in, find out if they’re a candidate. If somebody’s a candidate, the most

00:25:57.000 –> 00:26:03.000
Common symptom would be dryness, especially the first month or two after LASIK. So people use lubricating eye drops.

00:26:03.000 –> 00:26:08.000
We also have people use an antibiotic eye drop just to prevent infections to be safe.

00:26:08.000 –> 00:26:11.000
So they use antibiotic eye drops for about five days.

00:26:11.000 –> 00:26:17.000
Halos and glare are really common, especially in the initial healing process.

00:26:17.000 –> 00:26:22.000
Or if people have really large prescriptions, sometimes it takes a little bit longer for nighttime vision to be as clear.

00:26:22.000 –> 00:26:27.000
And then retreatment, I wouldn’t really say it’s a side effect, but

00:26:27.000 –> 00:26:33.000
The larger the prescription that somebody has, the more nearsightedness that someone begins with or the more astigmatism.

00:26:33.000 –> 00:26:38.000
Sometimes it won’t quite be 2020. So we let it heal. And after a few months.

00:26:38.000 –> 00:26:46.000
We can draw final conclusions. And if both ends are perfect, we’re done. If one eye is not quite 2020, we could always do a retreatment to fine tune it to get it to be perfect.

00:26:46.000 –> 00:26:51.000
And about two to 3% of people tend to do a retreatment if it’s not quite there, but

00:26:51.000 –> 00:26:56.000
Usually it’s one and done, but that’s where we do in the follow-up process, make sure people are right on target.

00:26:56.000 –> 00:26:58.000
Dr. Lange, what would you add?

00:26:58.000 –> 00:27:05.000
Yeah, so I agree with everything Dr. Mindy said. On the lens side of things, it’s quite similar. We’re really

00:27:05.000 –> 00:27:10.000
conservative here in terms of who we pick as our patient, you know, just as much

00:27:10.000 –> 00:27:17.000
as our patients come to see us and picked us from among all the options they have.

00:27:17.000 –> 00:27:22.000
we select our patients very carefully for candidacy.

00:27:22.000 –> 00:27:28.000
You know, we sometimes turn away as many as 20% of our individual that comes in for various reasons.

00:27:28.000 –> 00:27:33.000
Because the procedure itself is very well understood. This is not by any means experimental.

00:27:33.000 –> 00:27:38.000
lens replacement ALL and laser vision correction and ICL are all now established

00:27:38.000 –> 00:27:42.000
modern vision correction procedures and very well tolerated.

00:27:42.000 –> 00:27:48.000
And it’s really about finding the right individual. So one thing, Dr. Bendy mentioned dry eyes.

00:27:48.000 –> 00:27:59.000
That’s a very common we want to evaluate for because when you have a procedure on the eye, invariably you’re going to cause some irritations. And if you have pre-existing dryness, that can sometimes compound.

00:27:59.000 –> 00:28:11.000
There are various eye drops and things we may suggest before someone undergoes a procedure. And sometimes if it’s too severe, we may simply say this may not be the right option for you.

00:28:11.000 –> 00:28:16.000
I guess the main thing I’ll add is expectation. That’s really the thing.

00:28:16.000 –> 00:28:20.000
We have amazing technology that can dramatically improve

00:28:20.000 –> 00:28:28.000
people’s lives. But each person can come in with certain set of expectations that may not be realistic.

00:28:28.000 –> 00:28:30.000
You know, someone may

00:28:30.000 –> 00:28:32.000
have, you know, theoretically

00:28:32.000 –> 00:28:36.000
great distance and decent reading and noticed just a little bit of change

00:28:36.000 –> 00:28:41.000
And we can help guide them and say, hey, the amount of change we see right now is still very subtle.

00:28:41.000 –> 00:28:45.000
the benefit may not be 100% for you at this point. Maybe we’ll see you next year.

00:28:45.000 –> 00:28:49.000
Versus someone coming in, couldn’t see far, can see near

00:28:49.000 –> 00:28:54.000
or the degree of reading glasses dependency is very high.

00:28:54.000 –> 00:28:57.000
then the likelihood of being a great candidate can be higher.

00:28:57.000 –> 00:29:04.000
But it’s about selecting that right patient for the right technology at the right time is what we really

00:29:04.000 –> 00:29:06.000
drive in on.

00:29:06.000 –> 00:29:11.000
And one of the things before I go to you, Dr. Koshek, that I just want to point out, because I’m seeing it in the questions and in the chat.

00:29:11.000 –> 00:29:13.000
People want to know, do we treat

00:29:13.000 –> 00:29:17.000
Nearsightedness, farsightedness, can we take care of all the conditions?

00:29:17.000 –> 00:29:25.000
And so let’s start, let’s kind of start there. And also any comments on side effects that you wanted to bring in?

00:29:25.000 –> 00:29:30.000
Yes, I can start off with this. Basically, to answer that question, Sharif, that you just brought up.

00:29:30.000 –> 00:29:46.000
Do we treat farsightedness? Do we treat nearsightedness? Do we treat astigmatism? The simple answer to that is yes. We can treat all of them. I think in your comprehensive evaluation will determine kind of the best procedure for you to address your individual

00:29:46.000 –> 00:30:00.000
eye needs. So yes, we can treat that and we will tailor that to you. The question about side effects, I think this is an aspect of going last in this order. Dr. Bindi and Dr. Lang already did such a great job.

00:30:00.000 –> 00:30:12.000
So I don’t want to reinvent the wheel here, but I will mention, because I was looking in the comments and I had some people asking questions about specific things like monovision or blended vision.

00:30:12.000 –> 00:30:25.000
And things of that nature. So I don’t want to get too detailed on that, but I would say that there are certain things that patients can notice with something like blended vision or monovision that are best kind of discussed in person with the

00:30:25.000 –> 00:30:50.000
with the surgeon. Sometimes you might have read online or seen videos or heard from friends that, oh, I noticed maybe a little bit of a halo or I noticed a little bit of a glare. And these are things that we’re all familiar with as surgeons and we are able to determine whether this will be something that you experience after you have surgery. And we can give you even likelihood and probability ratios of these kind of things.

00:30:50.000 –> 00:31:06.000
So I think that’s what’s so important with your consultation with us is that we go through all your scans, we look at your eye in detail, and we’re able to identify things before we even do a procedure on you. That way you have all the information

00:31:06.000 –> 00:31:10.000
And we are doing the most safe and effective procedure for you.

00:31:10.000 –> 00:31:17.000
And while I get the next slides right up, Renee, could you come on camera? Are you able to do that? That’d be great.

00:31:17.000 –> 00:31:24.000
Renee, welcome. Thank you for everything you’re doing in the background. Could you just, you’re a CLR patient of our practice. You had CLR, I think.

00:31:24.000 –> 00:31:27.000
About two years ago, what was it like for you?

00:31:27.000 –> 00:31:38.000
I did. I was not a good LASIK candidate and I started, you know, I went from the reading glasses to needing distance glasses. I had to wear glasses for kind of everything I was doing.

00:31:38.000 –> 00:31:50.000
Getting very frustrated with that. So I decided something had to be done. Came in for an evaluation and determined CLR would be a good option. I was a little skeptical, not quite sure what to expect.

00:31:50.000 –> 00:31:54.000
came in, it exceeded my expectations tenfold.

00:31:54.000 –> 00:31:59.000
And one of the reasons I’m sitting here chatting with you today.

00:31:59.000 –> 00:32:05.000
And do you ever wear glasses for anything?

00:32:05.000 –> 00:32:06.000
Oh.

00:32:06.000 –> 00:32:11.000
I did. I started with reading glasses. Then I went to, I had to wear different glasses for tennis, for driving, for whatever it was I was doing. And it just got a little cumbersome.

00:32:11.000 –> 00:32:16.000
Yeah, and I think now that you have eliminated glasses mostly, but are there times when you might need to put on a pair of readers?

00:32:16.000 –> 00:32:26.000
Yeah, there are. The way that I was corrected, I chose to be corrected that way. And I don’t mind throwing on a pair of plus one readers at the end of the day, but I run out of my

00:32:26.000 –> 00:32:37.000
house every day. Look at numbers, you know, my phone, everything that I’m looking at, I do without glasses. And sometimes at the end of the day, the light is dim. I’m a little tired and I’ll throw on some plus ones.

00:32:37.000 –> 00:32:42.000
But I’m good. I’m very grateful.

00:32:42.000 –> 00:32:47.000
Well, and one of the points, I mean, Renee, you’ve had custom lens replacement i’ve had

00:32:47.000 –> 00:32:50.000
Epilasic PRK a long time ago.

00:32:50.000 –> 00:32:59.000
And each of our surgeons have had the procedure, one of the modern vision correction. And among the five of us, we’ve had all the five procedures, which I think is just a.

00:32:59.000 –> 00:33:06.000
testament to our own belief in this and that, I don’t know, Dr. Vindy is the saying, we eat our own cooking.

00:33:06.000 –> 00:33:07.000
Is that the saying?

00:33:07.000 –> 00:33:08.000
Okay, that works.

00:33:08.000 –> 00:33:16.000
So we’re big believers of this and the privilege it is to be able to serve the community.

00:33:16.000 –> 00:33:22.000
And help people go through this. But each of you as surgeons has mentioned the importance of the exam.

00:33:22.000 –> 00:33:28.000
Dr. Bendy, would you just review what we do when people come in? Because it’s very comprehensive.

00:33:28.000 –> 00:33:34.000
It is. So we refer to our comprehensive eye exam as our advanced vision analysis.

00:33:34.000 –> 00:33:41.000
It takes about an hour to an hour and a half by the time we do all the testing and meet with the doctor and the consultation.

00:33:41.000 –> 00:33:50.000
In total. And all the measurements you would imagine. So it’s corneal topography for corneal shape, corneal thickness, the prescription.

00:33:50.000 –> 00:33:54.000
In retinal scans, I mean, there’s a lot of measurements. We take over

00:33:54.000 –> 00:33:57.000
a million measurements of each eye

00:33:57.000 –> 00:34:04.000
During the course of that. And then that’s how we get the information. It’s a detailed analysis to see which procedure is appropriate.

00:34:04.000 –> 00:34:10.000
The way it works out is about 80% of the time people are candidates and there’s a procedure that’s a good fit.

00:34:10.000 –> 00:34:14.000
And about 20% of the time, we say it’s actually better just to hold off.

00:34:14.000 –> 00:34:19.000
So our perspective, our philosophy is during the consultation.

00:34:19.000 –> 00:34:23.000
What we specialize in is actually giving conservative advice

00:34:23.000 –> 00:34:26.000
about these modern vision correction procedures that work and

00:34:26.000 –> 00:34:32.000
Sometimes we say it’s better to hold off. Usually we have the right method and we can talk about it more in detail.

00:34:32.000 –> 00:34:40.000
I wanted to add one more thing. A lot of people come into the consultation and they will have talked to people, they would have done a lot of research coming in.

00:34:40.000 –> 00:34:43.000
And they come in thinking they know exactly what they want.

00:34:43.000 –> 00:34:49.000
And then when we look at the measurements, sometimes we have to steer them in a little bit different direction. It’s going to be better.

00:34:49.000 –> 00:34:53.000
For example, some people come in and they say they’re all ready to have CLR.

00:34:53.000 –> 00:34:57.000
But they’re only 28 years old. And we go, well, maybe that’s not the best treatment.

00:34:57.000 –> 00:35:01.000
So as just maybe a general way to guide things.

00:35:01.000 –> 00:35:07.000
If somebody is in their 20s, 30s, 40s, and early 50s, laser treatments often work.

00:35:07.000 –> 00:35:14.000
great. There’s a point where the lens starts to change and as people move through their later 50s, especially 60s, 70s.

00:35:14.000 –> 00:35:18.000
We might phase out laser treatments and think more about doing lens treatments, CLR.

00:35:18.000 –> 00:35:24.000
And so it really depends on the kind of how the lens is looking and all the other measurements.

00:35:24.000 –> 00:35:29.000
But that’s the purpose of the exam is find out what’s appropriate during the advanced vision analysis. Yes.

00:38:08.000 –> 00:38:18.000
And with that, Dr. Bindi, I wanted just to go to you and just ask you to explain

00:38:18.000 –> 00:38:21.000
What’s going on on this wall here?

00:38:21.000 –> 00:38:26.000
Oh, so this is a wall we have and as people enter our office, as they walk back and

00:38:26.000 –> 00:38:32.000
And these are pictures that the three surgeons here, we’ve all done one procedure on or another.

00:38:32.000 –> 00:38:38.000
And these are people who are wearing glasses or contacts. It’s just been a part of their lives, usually since they were

00:38:38.000 –> 00:38:42.000
In elementary school. And so they all wore glasses until they didn’t and

00:38:42.000 –> 00:38:46.000
So they had their vision fixed and now they just wake up and see.

00:38:46.000 –> 00:38:52.000
And so that’s just kind of the storyline of how people go from being dependent on something to just living their lives.

00:38:52.000 –> 00:38:58.000
And Dr. Koshek, I’m going to turn to you. Just describe what it’s like from your perspective as a surgeon

00:38:58.000 –> 00:39:02.000
Coming to work every day. What gives you juice?

00:39:02.000 –> 00:39:09.000
Yeah, so as you asked that question, I already started smiling. So hopefully that’s part of the answer right there.

00:39:09.000 –> 00:39:27.000
I love coming into work every day. It is a pure joy to be able to help patients see better, especially since I was a patient myself. So I’ve kind of experienced life with glasses and contacts. I’ve had a procedure done and now I don’t wear glasses or contacts. So I know what that whole journey is like.

00:39:27.000 –> 00:39:39.000
from patient one end of the spectrum to the other. So being able to talk to patients with that firsthand experience is really exciting for me. And then being able to offer such great procedures

00:39:39.000 –> 00:39:43.000
to improve vision is just incredibly satisfying and

00:39:43.000 –> 00:40:02.000
other family members who have had vision correction, such as my wife. And so it’s something that’s very near and dear to me. And I know it’s very near and dear to Dr. Bindi and Dr. Ling. So I won’t speak for them, but I’m sure they have the same kind of impression. It’s amazing to come into work and work alongside such great people to restore vision.

00:40:02.000 –> 00:40:08.000
Well, Dr. Bindi, you had all laser LASIK. Dr. Koshek, you had the Evo ICL.

00:40:08.000 –> 00:40:15.000
Dr. Ling, you had the smile procedure, and I believe your wife, who’s an eye doctor, has had one of the procedures. And I just want to hear from you

00:40:15.000 –> 00:40:27.000
Why do you love doing what you do? And also include, please, the range of patients, the oldest patients that you’ve treated, because those questions come up. Are you ever too old to have this done?

00:40:27.000 –> 00:40:36.000
So you’re never too old to have it done. We, of course, again, are very critical in terms of who we select to be our patients as well.

00:40:36.000 –> 00:40:38.000
And the oldest patient I’ve treated was 103.

00:40:38.000 –> 00:40:47.000
And we did custom lens replacement, take care of the cataract, also utilize a custom lens for that individual to maximize

00:40:47.000 –> 00:40:50.000
the vision there.

00:40:50.000 –> 00:40:52.000
But going back to the original question.

00:40:52.000 –> 00:40:57.000
is that you know what do I feel about the field I’m in? I feel

00:40:57.000 –> 00:41:02.000
that this is kind of like a happiness factory and we’re always trying to optimize you know

00:41:02.000 –> 00:41:07.000
we have a choice here in terms of how to leverage our technology for

00:41:07.000 –> 00:41:11.000
each individual and see what their expectations are and try to match it

00:41:11.000 –> 00:41:19.000
And we have gotten really good at that in terms of using cutting edge technology we’re very well

00:41:19.000 –> 00:41:26.000
connected with all the research and all the advanced options are coming out every few years.

00:41:26.000 –> 00:41:31.000
So we’re always at the leading front of vision correction.

00:41:31.000 –> 00:41:37.000
So we can always give the latest and greatest. And that brings me a lot of joy, just high-fiving patients all day long.

00:41:37.000 –> 00:41:41.000
It’s kind of not a bad way to spend nine to five.

00:41:41.000 –> 00:41:42.000
Yeah.

00:41:42.000 –> 00:41:45.000
And the team here is absolutely fantastic.

00:41:45.000 –> 00:41:49.000
You know, not just the folks you see here in front of you today.

00:41:49.000 –> 00:41:51.000
But we have such

00:41:51.000 –> 00:41:58.000
an amazing skill set of team members working behind the scene in the OR with us in the clinic.

00:41:58.000 –> 00:42:03.000
whom you’ll meet when you come in for your consultation or speak on the phone with us.

00:42:03.000 –> 00:42:07.000
So it’s an absolute joy, our patients and our staff here.

00:42:07.000 –> 00:42:15.000
And Dr. Lang, I’m getting questions here like about does the fee, are there other fees besides the fee? And I just want to clarify, no, our fee is all inclusive.

00:42:15.000 –> 00:42:23.000
As Dr. Lay and Dr. Mindy said earlier, we do everything in our own office-based surgical suite. And the reason we do is

00:42:23.000 –> 00:42:30.000
For you, we want to make this an incredible experience, not just a great outcome, but an incredible experience as you go through it. That’s our goal.

00:42:30.000 –> 00:42:38.000
That was something that was very important to Dr. Bindi when he dreamed of this many years ago. And we’re just so glad that we’re able to provide that.

00:42:38.000 –> 00:42:48.000
Dr. Mindy, I like the way that you describe what we offer to patients, right? What Donald Miller would have us say about this to patients.

00:42:48.000 –> 00:42:52.000
What is the phrase that you like to use or that sentence?

00:42:52.000 –> 00:42:58.000
Well, I just say we offer conservative advice about modern procedures that work so people can simply wake up and see.

00:42:58.000 –> 00:43:04.000
As just kind of a catch-all, that’s really what we do. And I do think of this as, you know.

00:43:04.000 –> 00:43:07.000
We never want to forget what we’re here to accomplish. It’s just

00:43:07.000 –> 00:43:11.000
We’re here to help people see better, but this is a safety first kind of a thing.

00:43:11.000 –> 00:43:17.000
So I just recommend people come in, find out if you’re a candidate, do your consultation if you’re inclined to take a next step.

00:43:17.000 –> 00:43:21.000
And then you’ll find out if it’s a good option. You can decide if you want to do it or not.

00:43:21.000 –> 00:43:24.000
And so we look forward to meeting you in person whenever that time is.

00:43:24.000 –> 00:43:30.000
That’s right. And here’s the phone number. Someone said, please bring that slide back up, 408-984-1010 or our visit.

00:43:30.000 –> 00:43:40.000
Our website, 2020, S-I-T-E.com. But while we have one more surprise for you. While we’re going to formally end the webinar now.

00:43:40.000 –> 00:43:43.000
For those people that need to go, and I know two of our surgeons need to get back

00:43:43.000 –> 00:43:48.000
into clinic and surgery this afternoon. Dr. Koshek has a little extra time.

00:43:48.000 –> 00:44:05.000
And so Dr. Kaushik and I are going to stay on in what we’re affectionately calling the after party. We will answer questions. So those of you who want to stay on and ask questions, we’re going to answer them as many as we can. And if we don’t answer them, Renee will via email as long as you didn’t come in anonymous.

00:44:05.000 –> 00:44:12.000
Renee, I hope you’re checking both the chat because some people put them there as well as the Q&A. I mean, all this technology kind of

00:44:12.000 –> 00:44:21.000
Makes my head explode sometimes, but it’s been our privilege to be with you over the past 44 minutes. Dr. Bendy, as promised, I wanted to end on time.

00:44:21.000 –> 00:44:22.000
Okay.

00:44:22.000 –> 00:44:27.000
So we’re going to end the formal part now here, but Dr. Koshek and I are going to stay on for anyone who’d like to ask additional questions.

00:44:27.000 –> 00:44:31.000
Perfect. I’m going to sign out, but I want to say thank you, Sharif, Renee.

00:44:31.000 –> 00:44:35.000
Dr. Kosick, Dr. Lang, we’ll see you after work, and you’re all set to go.

00:44:35.000 –> 00:44:36.000
All right.

00:44:36.000 –> 00:44:37.000
Enjoy the after party.

00:44:37.000 –> 00:44:38.000
Thank you, everyone. Take care.

00:44:38.000 –> 00:44:39.000
Thank you.

00:44:39.000 –> 00:44:40.000
Happy Friday. Bye-bye.

00:44:40.000 –> 00:44:45.000
Thank you, doctor, and thank you, Dr. Lang, as well. Okay, so I’m going to look at the questions now.