Step #1 to Getting Rid of Glasses Webinar: Sept 20th

[00:00:00] So let me begin, uh, by first of all, just welcoming everybody. Uh, thank you for coming to our webinar. We’re, we’re gonna learn about custom lens replacement, and on the screen here, you see, uh, Jack Armstrong, some of you might know him from the.

[00:00:13] Armstrong and Getty show is a nationally known radio broadcaster, and he had C. L. R. With us a few months ago. He’s been now talking about it on the radio, and you can see down there in the corner down low. You can see what he looked like before C. L. R. And now he is living life glasses free and celebrating there with Dr Lang, our C.

[00:00:32] L. R. Surgeon. My name is Sharif Madavi, and I’m in charge of patient experience here at the Laser Eye Center, and it’s a privilege to work with everyone on the team, and we have with us today two of our surgeons, Dr. Craig Bindi, Dr. Joseph Ling, and I also want to welcome Renee. Renee, She works for Laser Eye Center, and she’s going to be monitoring the Q and A.

[00:00:56] So if you’ve got a question, you can see on the bottom of your Zoom panel, a Q and A button. Simply submit the question to her. We’re going to answer as many as we can during this session. But if it doesn’t get answered here, we are going to Uh, follow up with you via email. As long as we have your email, we likely won’t be able to monitor the chat.

[00:01:16] So, uh, it would be harder if you put if you put messages in the chat. It’s just hard for us to be able to, um, to, uh, to show that. But, uh, we’ve got everything up on the screen here and I want to just confirm Renee. You can see the full screen with the slides. Correct. Perfect. Perfect. Um, I’d like to begin with describing the why of the laser eye center, why we do what we do.

[00:01:39] And I think this little 30 second video clip of this gentleman, Jack, he is just waiting as his wife has CLR. And here’s what that moment looked like right when the procedure was finished.

[00:01:57] So Christine, Christine, Christine, how was that for you? So easy, very, very easy, simple, felt nothing the entire time, just a great process in the middle here. Come on. Yeah. Awesome. for letting us take care of you, Christine, we’re going to see you tomorrow morning. Yes. Okay. Absolutely. All right. Thank you. You know, it’s such a privilege for all of us.

[00:02:22] And that just little, little vignette really illustrates. It gives me goosebumps. Every time we see a patient come out of the lens room or out of the laser room and, uh, the ability to do what we do is such a privilege for our surgeons, all our doctors, our entire technical team, everyone working in laser eye center.

[00:02:40] Um, today, what we’re going to learn. So what we’re going to talk about today is custom lens replacement. We’re gonna describe what it’s about and really get into how it is different from LASIK, which is a procedure that most of us know about and have known about for a while. We’re going to talk about recovery, what possible side effects happen, where we do the procedure, and we’ll finish up talking about cost and whether or not it’s covered by insurance.

[00:03:00] Um, but first, I want to introduce you, Dr Bindi. Uh, welcome, Dr Bindi. Dr. Craig Bindi has been performing. refractive surgery now for almost, what, almost 25 years, Craig. It’s just, it’s so great. I just thought I’d like to welcome you if you had some opening words. Uh, well, for sure. Thank you, Sherif. Thanks for, um, for teeing this thing off and, and welcome to everybody.

[00:03:23] Uh, all, all these people who have joined on for this webinar, take time out of your, um, your Friday, and, uh, we’re going to cover a lot of ground today. Today we’re mainly focusing on, on CLR. We’ll be talking about other techniques in modern vision correction as well. Um, but I think most, most of the people on this webinar, if you’re here, there’s probably something you can relate to where people, whether they’ve worn glasses and contacts their entire life, or they just start to notice as they move through their 40s and 50s and 60s.

[00:03:52] that something changed with their near vision. And, and in 2024, it’s really not too much to ask to be able to drive to a movie theater and read a menu at a restaurant or to play tennis and also look at your cell phone without constantly needing glasses and contact lenses. And so we’ll be talking about what we refer to as Modern vision correction.

[00:04:12] These are these five different procedures that Dr Ling and I specialize in and how do we go about deciding what, what, um, what works best for people, how people are a candidate. So we have a lot of, a lot of ground to cover. So Sharif, I’ll give it back to you and let’s kick this off. Dr. Bindi, let’s start right there.

[00:04:28] Uh, you know, here’s a little bit of anatomy. We don’t want to get too into it, but what is it that we’re doing in modern vision correction to improve vision for LASIK, for example? Sure. Well, first of all, when people want to see clear, we want light to be perfectly focused on the retina. So, if you look at that slide you have there, as light comes in through the front part of the eye, light’s passing through the cornea, and then the lens behind it.

[00:04:49] And we want a clear focal image on the retina. And so, generally people wear glasses and contacts in order to see clear. Um, first I’ll talk a little bit about laser vision correction, because most people are familiar with it. or they have friends that have been LASIK over the last 20 years. Um, and LASIK is a laser procedure where we laser on the very front part of the eye.

[00:05:09] You can see where that cursor is and using laser light, we can reshape the cornea and it treats the prescription. So if a person wears prescription glasses or contact lenses by reshaping the cornea, we can put all the light focus on the retina. then people don’t need to wear prescription glasses and contact lenses and that’s, uh, and this is laser vision correction and the three subtypes of LASIK including all laser LASIK, epi LASIK, and smile LASIK.

[00:05:34] And, and it works amazingly well. I’m sure everyone knows people who’ve had LASIK. Um, at the same time, as people get older, as they move through their 40s and 50s and 60s, um, The internal lens in the eye begins to get less flexible, and that’s when near vision starts to change, and that’s the whole twist to the plot.

[00:05:53] That’s what Dr. Ling and I are going to be talking about, how to fix that problem. It’s an age related issue that affects near vision, and we can talk about that also. Well, it’s a great moment for me to introduce Dr. Joseph Ling, who is a highly experienced, Lens based refractive surgeon. He also does LASIK, but he is one of a handful of surgeons in the country who who do this to the exclusion of everything else.

[00:06:16] And we’re so privileged to have him as part of the practice. So, Dr Lang, welcome. And I’m going to bring up another picture of the eye here. So what what happens? What is this thing? Dr Bindi is referring to where we all of a sudden need glasses to see up close. Why does that even happen? All right. Thank you, Sharif.

[00:06:32] Thanks, Dr. Bindi. Um, so actually, Sharif, you see that button on the top right hand corner? There’s a slideshow button. Um, you can click on that. I think it’ll expand it and make it a little bit bigger for us here. There we go. Um, so right now we have a cross section of the eye and you see that in the front part of the eye there is a lens structure.

[00:06:53] behind the cornea. That is the aging component of the eye. So as we age, our vision changes, and it largely stems from this structure. It is a fantastic anatomy here that allows us to see clearly when we’re younger. There’s many people who were born without much prescription, and they could see far and near, and that ability to see far and near It’s a dynamic process that many of us, you know, has taken for granted until we turn 45 because at 45 that lens starts to deteriorate and that deterioration leads to hardening and lack of flexibility in that lens.

[00:07:33] And that’s why we lose the ability to change our focus from different distances. Dr. Lin, can you see the focusing on that animation I put on the screen? Yes. Yep. So you’re demonstrating the, the act of accommodation, which is that changing and focus of the eye. And does the patient, does a person need to do anything or does this happen automatically as we move through the world and are looking far and then up close?

[00:07:59] You take it for granted because we realize, we don’t even realize this is happening. Uh, we just thought we just could see, but it’s a dynamic process that requires effort, but it’s not within our control. Got it. Okay. And I’m going to go back now. I’m going to take the next slide and I’ll hit that slide show button.

[00:08:15] There we go. Okay. Let’s talk now about what CLR does, if you would, and in the context of why we even need to consider doing custom lens replacement. So 45 hits and the lens starts to change, essentially deteriorate. I guess our body never knew we were going to live past the age of 45. Um, but our lens, lenses really starts to lose the ability to focus properly.

[00:08:40] So on the left hand side, you see that how a normal lens, Focus lights, light goes in, and hits the retina very, uh, squarely there. But then as we age, that lens hardens up, loses the ability to focus. The other component that also becomes worse is that the lens, in addition to becoming, uh, you know, immobile, it also loses its clarity.

[00:09:02] So it starts to develop haze, opacities, and we term that a cataract. So it’s a direct Uh, you know, linear process of needing reading glasses, needing progressive bifocals, and suddenly you couldn’t see well to drive at night because of the glare, or your vision prescription starts to fluctuate quite a bit, and it’s because of that lens that you see there on the right hand side.

[00:09:25] becoming kind of yellow tinted and scattering light all over the place. And, um, and, and, and then your vision just continues to, to go downhill. Well, Dr. Ling, could you explain, because some people say, well, is this the same as cataract surgery? So could you do a little compare and contrast? Yeah. So cataract surgery and custom lens replacement, uh, custom lens replacement share a lot of similarities.

[00:09:49] Uh, the, the fiscal act of retrieving that lens out, the aging lens and placing us a new lens in. pertains both to cataract surgery and CLR. However, CLR is considered a more elevated form of cataract surgery. It depends on, uh, surgeon, uh, techniques, depends on the technology we use to facilitate the replacement of that, uh, aging lens.

[00:10:16] So in CLR, our goal is vision correction. The removal of a cataract or a dysfunctional lens that has yet to become a cataract is just as simply a byproduct of what we do in getting you out of glasses. So, uh, the benefit of CLR would be that the vision would be very stable for the, for the remainder of your life.

[00:10:39] There’s really not much fluctuations that you would receive in your vision due to an aging lens, because there won’t be an aging lens anymore. And thereby, you also will never develop cataract going forward. You’ll also never need cataract surgery. And those are all the secondary benefits. The main benefit is this new high end synthetic lens that we will guide you towards based on, you know, your anatomy, your needs.

[00:11:00] We’ll find out how these high end technologies, uh, optics, Can best benefit you and through that lens, it corrects for prescription, help you see far, help you see near and, and we want this process to be tailored specifically for you because there are many different lenses that we can choose from as well.

[00:11:17] And Dr. Ling, we know that, uh, from the data that most patients having cataract surgery are in their mid seventies to early eighties when it fully forms. But what about CLR? What is the age when many people are choosing to have custom lens replacement? Yeah. Um, I mean, actually the average age for cataracts actually coming down, um, usually it’s around their, you know, late sixties.

[00:11:37] Now the average age for us on the custom lens replacement front is typically around the late fifties to early sixties. Typically that’s when the burden has crossed a certain threshold and you see that, man, I’m in glasses all the time. I can’t drive at night anymore, or, you know, I can’t follow the golf ball.

[00:11:55] That’s a, that’s a big one that we see a lot. Uh, when I, when I hit it. Uh, you know, take care of a lot of people that want to remain active, but they found that their vision simply cannot keep up like it used to. And just to add what Dr. Ling was saying, um, good description, Dr. Ling, and I was going to say, it’s a gradual process.

[00:12:13] So in the 40s, people first notice their near vision gets worse, and we all, we, we describe that as stage one, dysfunctional lens syndrome, stage one. Um, the lens gets less flexible, readers and bifocals. Stage two is when the lens gets a little bit yellowed and discolored, that’s more like in the 50s. And then later on the.

[00:12:29] The sixties or seventies, that’s when the lens gets cloudy, cloudy and opaque. So it’s, it’s, this is, this is a process. If we see somebody in their late forties, LASIK still might be the treatment of choice. If we see someone, and as we, as we look at their eyes in the exam room, if we see the lens is changing, it’s yellow, it’s getting a little cloudy.

[00:12:47] We might tilt the equation a little bit to say. Maybe CLR is going to be a more, more appropriate choice. And so that’s where through the consultation, Dr. Ling and I can really help to guide people along is laser going to be more appropriate or is it more of a lens treatment that’s going to be more appropriate?

[00:13:01] Well, and also Dr. Bindi, um, one of the, uh, one of the criteria that you had very early on when you were thinking through how we want to add lens procedures to what was traditionally a LASIK practice years ago, Um, there were some things that were very important to you and, and here we see the image of our, of our suites, but can you talk about how we do the, where we do them and how many, do we do both eyes at the same time?

[00:13:25] Kind of give a little overview. Sure, sure. So, well, first of all, I was excited to see a lot of the people on this webinar, people that I actually performed LASIK on some 15 or 20 years ago. And so they’ll remember in their mind what it was like to go through LASIK. When they did it, a lot of time has passed, technology has evolved.

[00:13:41] But I bet if you ask those people, what do you remember about LASIK? I bet they’ll say something like this, LASIK took about 15 minutes, it didn’t hurt, and they were normal the next day. We describe that as a LASIK experience. And, and as these other procedures start to develop and evolve, things like EVO ICL and CLR, we wanted our patients to have the exact same experience.

[00:14:04] as a LACE experience, regardless of the procedure. And so, um, these are our operating rooms in our office. Um, our facility has evolved a lot over the years. The technology has evolved. But it’s still that same kind of process. If somebody does CLR, they walk into the room on the right of that picture. You can see Dr.

[00:14:21] Ling. Uh, they lay on that bed for 15 20 minutes. Um, CLR is a procedure that it takes about 5 10 minutes per eye. The anesthesia like LASIK is numbing eye drops and we do, we still give a pill of allium because people get nervous. So, so that helps take the edge off. But, um, but when people are all done, I guess you saw in that video that you played to begin with, um, it’s, it’s like a LASIK experience.

[00:14:45] If someone’s gone through that before, had a friend who’s had LASIK before, um, we do both eyes on the same day, whether it’s LASIK or Evo or, or CLR. And so people come in in the morning, they do their treatment. Um, They do need someone to drive them home because it’s not that clear that day and they’re on Valium.

[00:15:02] And then we say it heals within, it’s overnight recovery, within a day or two people are back to their normal activities. So that’s kind of how the process goes for people who are familiar with that. Sure, now that’s, that’s, it’s, it’s, it’s amazing that, you know, how this has evolved from the days of, you know, cataract surgery years ago was done in a hospital and then in a surgery center.

[00:15:20] Now we have the office space surgical suite available to offer patients. And of course, doing both eyes at the same time. is Dr. Ling will share is far more convenient than separating them out by a few weeks. Correct, Dr. Ling? Yeah, studies have been done, uh, looking at, you know, obviously safety. Should we do one eye separate by the month or should we do one eye separate by a week or can we do both eyes on the same day?

[00:15:44] And there’s actually been extensive, extensive studies on this topic and it has demonstrated that it is just as safe. And much more efficacious for the recovery of the patient to have both eyes done on the same day. Uh, because then the recovery and the adjustment to the new vision would be on pace, on course for both eyes.

[00:16:04] Because vision, again, is a binocular process. Uh, if you have one eye done, you’re kind of delaying that adaptation until the second eye is done. Um, but again, we’re open to any sort of patient preference. Some patients just simply like to do one at a time. I completely understand, um, but we’ll always, you know, give our recommendation in terms of what we think is appropriate.

[00:16:29] And as we move to this next slide, before you start talking about different lens types, um, we did have a question that came up about, will this just correct for myopia or for just, I’m sorry, just for near vision or does it do distance vision as well? Can you just clarify that for everybody? Yeah, so it depends on the lens, uh, the lens we use.

[00:16:46] We call these lenses that you see here on your screen IOLs, intraocular lenses. So these IOLs are what allows us to have focus, correction, and depending on the different types of technology built into these lenses, it can allow you to see far really sharply, it can help you see near at a range, or it can help you see both.

[00:17:12] And there are pros and cons to all these lenses. Um, I tell all my patients as gray and amazing these lenses are, there are no perfect lenses. It really depends on your anatomy. We have, uh, many advanced diagnostic, uh, uh, you know, machines to see how your eyes perceive lights, make sure all your, uh, anatomies are healthy, and then we can match your lifestyle, your goals, your expectations.

[00:17:39] So when you come in, we do an evaluation. We hear kind of what works for you, what you’re looking to achieve, then we match these technologies. So there are many different types. And Dr. Ling, I want to, I’m just looking at some of the questions coming in and they’re around other conditions that affect vision, such as glaucoma or retinal issues.

[00:17:56] And one gentleman had a retinal detachment, but you know, he’s been taking care of that. What do you do when a patient comes in and you suspect something might not be, uh, optimally healthy in the eye? Right. So there can be many reasons why someone, uh, you know, has issues seeing well. So one can just be, you know, a need for glasses.

[00:18:16] That’s very straightforward. You know, we’re, you know, we’re a vision correction center. We get people out of glasses and contact lenses through six, you know, different procedures. But then, there can be other pathologies or diseases that can affect how well your eyes can see. And it’s not a glasses or contact lens issue.

[00:18:32] You know, things like macular degeneration, things like glaucoma, things that you have mentioned before. Um, and it’s a case by case basis, and it depends on severity in many cases. You know, glaucoma is a very common condition. It can range from very mild and well controlled to very severe and vision threatening.

[00:18:51] I have done procedures on mild, well controlled glaucoma patients, uh, without any issues. They have their glaucoma specialist who’s monitoring them, and they do great with this procedure. In fact, custom lens replacement lowers eye pressure, uh, when you extract the cataract lenses. Um, you know, I have done surgery on patients with macular degeneration, given that it is mild, it is well controlled, they’re seeing a retina specialist, and we pick the lens that’s most appropriate for that condition.

[00:19:17] You know, we want lenses that best, uh, optimize the vision, even as the maxigeneration, uh, gradually progress. Retinal detachment is something that can occur, but if it’s corrected and fixed with surgery by a retina specialist and still looks good, that’s something we can also consider. So, um, we got to see it case by case.

[00:19:38] Um, we have to see kind of what the situations are. As much as, uh, we love to fix. You know, everything we’re, we’re evaluating each person’s ability to succeed, and we only really want to do surgery on people who had the best chance at improving, and we’ll explain why if we decide to decline to do your surgery.

[00:19:58] I’m just going to do a little back and forth between Dr. Bindi and Dr. Ling. So, Dr. Bindi, astigmatism, it’s coming up in the questions. Let’s just kind of tell people about how we take care of that. It always does come up, and one of the most common questions people ask in the consultation is, I wanted to get my vision fixed for years, but I know I can’t because I have a stigmatism, but, but we’ve been fixing a stigmatism since 1999 when it was approved by the FDA with laser, um, a stigmatism is very easy to treat, um, people can wear glasses or contacts, obviously, um, all the versions of laser vision correction, treat a stigmatism, it’s actually more common to treat, um, People who have astigmatism, compared to people who don’t have astigmatism, because usually people have a little bit.

[00:20:41] And so, um, whether it’s a laser treatment or a lens treatment, we can fix astigmatism. And actually, it, because of the, the, the basis of astigmatism, we can actually correct it better with a laser or with a lens. Glasses, you can get some strange distortions. People might not like their nighttime vision.

[00:20:57] Contact lens is the treat for astigmatism. They can rotate. They’re less comfortable. So when we fix astigmatism at the source within the eye, uh, with a laser reshaping procedure or lens, we can fix it. And that’s pretty routine nowadays. Dr. Lange, um, a gentleman is asking if he’s too old for the CRLL, CLR LENS treatment.

[00:21:17] And um, how would you answer that? I want to tell you his age, but you’ve treated some patients. So what’s some of the oldest patients you’ve treated now? The oldest patient I’ve treated was 103. Um, and he did great. And so there’s, there’s not an age limit. We of course want to make sure. Uh, you know, you’re healthy, you’re able to tolerate the procedure, and that, you know, you’re able to just go through that process.

[00:21:41] But, remember, a custom lens replacement is to treat the age related component of the eye. So, the, that component only gets more in dire need of something like CLR as we progress. So if, you know, typically it’s more so you may be too young for custom lens replacement, your natural lens still functions very well.

[00:22:02] Then we can do something like laser vision correction, or ICL to correct for the inborn need for, you know, glasses, or, you know, sometimes even someone in their 40s, maybe even early 50s, we can consider laser vision correction. Yeah. And, and whether someone’s 18 years old or they’re 103 people just want to simply wake up and see.

[00:22:23] And so my advice anytime someone says Can I do it? And then they have their own special scenario. I say the first step is to find out if they’re even a candidate. It works out that about 80 percent of the time when Dr. Ling and I, we do our consultation, we call it the advanced vision analysis, but that’s where people actually come into the office.

[00:22:41] We take about a million data points and that’s where you can start to guide people along and see if it’s actually safe. 20 percent of the time we say it’s preferable to not do it or stick with glasses or contact lenses, but about 80 percent of the time we can. And in general, people at the younger age of the spectrum, we tend to do laser treatments.

[00:23:01] Um, if somebody moves through their forties, maybe they’re not quite ready for a lens treatment. We might do LASIK perfect distance vision. People might eventually need reading glasses as they get older. Or sometimes we’ll do something called blended vision where we can, it’s an age adjustment with a laser where we can still preserve near vision.

[00:23:16] We leave a little bit of nearsightedness so people can do distance near things without glasses. And then as people move through the fifties and sixties, it tilts a little bit where we might say maybe a lens treatment like CLR is more appropriate. So on a webinar, we can never tell exactly what each of these people on the webinar, what their best candidate for, but I say they could find out if they’re a candidate.

[00:23:36] We do a direct one to one consultation. We help them along and let them know our thoughts. rationale. Dr. Bindi, because the questions are coming up. Um, someone had LASIK with you 15 years ago, 20 years ago. Can they have CLR with Dr. Ling or Dr. Koshek? Next month. Uh, probably so. So first of all, hello, welcome back to the Laser Eye Center and, and without a doubt, so LASIK fixes prescriptions, so people see 20 20 and it can last a long time, but LASIK doesn’t really block the aging process.

[00:24:06] So it’s not uncommon for these people in that scenario, people come back and they say LASIK was great for 15, 20, 25 years. For example, I had my LASIK. 25 years ago here as well. As people get older, they might start to need reading glasses or, or bifocals. And then sometimes the laser treatment to fine tune it with a laser is appropriate.

[00:24:25] Other times we say it might be more appropriate to do CLR with Dr. Langer, Dr. Koshak. Absolutely. Yes. Um, Dr. Ling, I’m going to bring up this image once again of the lenses because we’re getting questions about, you know, multifocals and the light adjustable lens. So could you just do a brief touch on that?

[00:24:41] I think people want to understand this notion of blended vision. That’s the sense I’m getting by summarize the threat on some of the questions. Yeah, so there’s different types of strategies to get people out of glasses and to match different goals because there are still limitations in what all these lenses can do.

[00:24:57] So let’s just talk about different major subtypes. Okay. So we have a monofocal lens and these come in torque configuration, which can correct for astigmatism. These give you very high quality images. So if you’re like a birdwatcher, a truck driver, a pilot, usually at one, at least one of these in one of your eyes, give you really sharp, high fidelity, high contrast.

[00:25:18] Image. Now, like I said, no perfect lenses, right? So this lens can only have one fixed focus point. So if you’re trying to just see up close, if we’re tired for distance, uh, then you wouldn’t be able to read in that eye with this really sharp, high-end monofocal toric lens. But then in your other eye, then we can use strategies.

[00:25:38] Either we can do something like blended vision, which is a higher form of monovision, so that your, uh, your contralateral eye can use an extended depth of focus lens. Uh, this lens can have a range of vision, and if we’re targeted for more intermediate and near, then you get ability to see your computer, your dashboard, you can see your phone, dinner menu in the restaurant, and between the ultra sharp distance eye, and then the extended depth of focus, we call that blended vision.

[00:26:05] It works really great. for many of my patients who likes to have that balance. And we can also have patients who are great for multifocal lenses as well. It depends on some of our testing here. Some patients are not good for it just based on how their cornea looks is how they receive light within the eye.

[00:26:24] We have a high end diagnostic tool that does ray tracing technology through, through the eye. And we can see, okay, you’re a great candidate for multifocal. Here are the benefits. Here are the side effects. So multifocal lenses splits the light across far intermediate and near. So essentially the full range and it sounds great, but then it can give you a little bit.

[00:26:43] Loss of contrast of the far, far distance. So if you are that pilot, that, you know, huntsman, that outdoorsman, uh, or truck driver, you may want to consider, you know, whether that’s right for you. Maybe you do want to see, you know, that twig on the tree, a hundred feet far away, you know, because you’re sharing that light in a multifocal lens across a wide range of distances.

[00:27:05] So if you are someone who, you know, doesn’t do all that outdoor stuff, you’re someone who likes to go out, play a little bit game of golf, a little pickleball. Go to the restaurant, watch something, you know, on the TV. Multi focal lens is amazing. Um, you know, it’s great for someone who had tried blended vision or monovision, didn’t like it.

[00:27:24] Then a multi focal lens can work very well for you. So each person, uh, you know, come in with their own expectation of what they’re used to, what they’re hoping to achieve. And we also take that into account while we look at your eyes to see which one we recommend for you. And Dr. Ling, since people are asking about the light adjustable lens specifically, because now we’ve been doing this and Dr.

[00:27:48] Bindi and Dr. Ling pride themselves on always offering the best technology for that, for each patient. Uh, and we now have the light adjustable lens in our, in our toolkit, so to speak. Could you just describe what that is? A light adjustable lens is a very unique, lens in the market right now. It’s considered a monofocal lens, uh, at baseline in which it has like a single, very clear, sharp focus lens, but it’s a special power or the special trait, if you will, is adjustability, meaning that even after the procedure, when the lens is in place and you’re living with it, you’re healing with it and recovering from it, And we let the, we see what the vision is like, you know, down the road.

[00:28:30] And if we ever want to make any adjustment to the power, all we need to do is shine a light onto the light adjustable lens. You can make it a little bit more far sighted, a little bit more near sighted. You can fix your astigmatism. So you can, you can almost, uh, kind of trial things out. And, and alter the power of the lens to match kind of what you want to try.

[00:28:51] Uh, I mean there’s a finite numbers of adjustment you can make. So typically we’ll still have a good plan to go with. So hey, we want to do blended vision or we want to go both eyes for distance, uh, of that sort. And then really dial it in. once we get to usually about a month out. Um, where this lens really is great for, uh, and you’ll find out if you had LASIK before when you come in, is that we usually use this lens for patients who had prior refractive surgeries.

[00:29:17] Uh, having had LASIK, PRK, SMILE, or RK, which is an older, more traditional vision correction procedure that’s really not performed today, but even if you had RK, we usually would use a light adjustable lens to, to rejuvenate your vision, restore the focus because having had prior refractive surgery can sometime alter the accuracy or the, the, the calculation of what the power of these lenses need to be.

[00:29:44] So if you have a lens that can be adjusted, then we can typically. land it. We can get that hole in one, uh, you know, using golfing analogies here to, to get that focus in place. And Dr. Ling, I’ve got here a picture of you, uh, doing procedure then talking to that patient almost immediately afterward. Could you describe what to expect?

[00:30:03] What would a patient expect on the day of surgery and the day after surgery? Yeah, like Dr. Bindi mentioned before, you know, it’s very much like a LASIK like experience. So for those who had LASIK before, you can use that as a point of reference. For those who haven’t, it’s a quick 10 minute procedure. Um, the eyes fully anesthetized is minimally invasive.

[00:30:21] The technique I employ. are laparoscopic in technique, which means micro incisions, no stitches, no sutures, self sealing incisions, all done within 10 minutes. During that 10 minute process, you’re looking towards a bright light, a microscope light. You don’t see anything scary or unusual. You’re just listening to music.

[00:30:39] We take requests and usually about three songs in, you’re going to be done with that eye. So, uh, the entire process is comfortable because our anesthetic works really, really well. You don’t feel any discomfort or pain. And so, so a lot of it actually comes from, uh, you know, just nervousness of having a surgery.

[00:31:00] That’s usually what we, um, you know, focus on and try to alleviate. So, You know, we do our procedure at the same location you’ll have your consultation. It’s going to be a familiar area. It’s not like going to a hospital where you don’t know which floor you’re going to. It’s already, you know, you’re off to a bad start when you don’t even know where you’re trying to get to.

[00:31:15] You’ve never been there before. And then, so it’s a familiar place, familiar faces, and it’s a comfortable environment so that we really lower the amount of stress you have. You don’t get IVs, no one’s poking at you in the arm, and there’s a little bit of dose of Valium, too, for you, which will, uh, really lower that level of mental, you know, anxiety that you may have.

[00:31:38] And then I’m very good at talking through my patient through the procedure if they wish or they’d rather just listen to music, I can, you know, keep my mouth shut too. And, uh, and patients do really well with this. Some patients even don’t take Valium because they remember, you know, I took it before for something else, I didn’t like it, and they do great with just pure topical anesthesia as well.

[00:31:56] And there’s the patient on the right hand side that had the procedure just a few seconds ago. Sunglasses on, no bandages over the eyes, uh, vision will be a little foggy, um, so, you know, when we’re done, It’ll be a little foggy, but you can put on sunglasses and navigate to your driver’s car and just go home, take a nap.

[00:32:13] And typically next day, dramatic improvement in vision, as well as how the eyes feel. Dr. Ling, we’re privileged to have one of your patients with us on the webinar today. So I’d like to introduce Renee and Ray, would you just share a little bit about your experience, kind of what you’re, what you were frustrated with and what life’s been like since you had CLR, Dr.

[00:32:33] Ling. Certainly, thank you. Uh, yeah, I was not a good candidate for lasik. Um, so I hit my mid forties and I started needing these reading glasses that I, uh, really pretty much hated. Uh, those evolved into kind of different glasses for whatever I was doing, whether I was playing tennis or driving or reading or at the computer, kind of whatever I was doing.

[00:32:53] I had about three pair of glasses at the ready and got really frustrated, um, and came in to meet Dr. Ling, uh, was determined that I was a good candidate for CLR. And, uh, went from wearing glasses 100 percent of the time to wearing glasses, maybe less than 1 percent of the time at late night, dim lights. I might throw a pair of plus one readers, but I leave my house every day without any, and I’m working around the world without any glasses.

[00:33:21] And it’s been an amazing life impactful, uh, procedure for me. And how’s your pickleball game since you had CLR? It’s never been better, and I blame my eyes. So, you know, by the way, those of you who are asking questions, Renee is the one who’s going to be answering and just be patient. If you don’t get it immediately after within the next couple of days, we typically have dozens of these that we need to answer for people and we want to give each and every one of you the attention you deserve.

[00:33:50] Renee is also one of our counselors. She does virtual consultations and she does consultations. Um, in person consultations in our Pleasanton office. So Renee, thank you for being available to be with us today and for keeping track of everything that’s been going on. My pleasure. Um, we already covered pain, we covered a lot of things.

[00:34:06] Um, Dr. Ling, I think you covered side effects already, talked about side effects or what people can expect. Um, let me ask you this, how long will vision last after CLR? Yeah, so lens replacement takes care of the aging component of the eye and a lot of that vision change we experience throughout our life comes from the lens.

[00:34:27] So by replacing the lens that’s aging with a synthetic lens that does not age, the rest of the eye actually stays fairly static. So with a lens that doesn’t change, within a static eye that’s in great focus, you can expect the vision after lens replacement to last pretty much the rest of your life. You will not develop cataract, you don’t need cataract surgery.

[00:34:49] Um, so we expect it to be a very stable and permanent solution for you. Fantastic. Um, how do we know, Dr. Bandy, how does someone know if they’re a candidate? Can you just reiterate what we want them to do? Sure. I mean, the first step is really to come in. Um, everyone’s on a different, um, journey where they are in the process.

[00:35:08] Some people just want to get information on our website. You know, there’s a lot of information. Some people ask real basic questions like, How much does it cost? And they, and we can go over those things as well. We have a, um, uh, like a virtual consultation. People can do that. Ultimately, uh, my advice is to come in and get things, um, checked out, uh, advanced vision analysis and meet with, um, Dr.

[00:35:29] Ling or myself or Dr. Koshak. Um, just to see what’s appropriate and then we’ll guide people along, explain our rationale, say which procedure is appropriate. You can meet with the actual surgeon if you have more, um, specialized questions to ask. Um, but yeah, it’s, it’s come in for the consultation. Very good.

[00:35:46] And, and by the way, um, people are asking about insurance and what is the, first they’re asking about what is the cost for the advanced vision analysis? So what does that cost? Dr. Mindy? Well, that’s that’s just part of the that’s just free. So people come in. It’s a complimentary consultation. We don’t we don’t charge for that.

[00:36:03] Although many patients will tell us far and away. It’s the best eye exam they’ve ever had because of the just all the different equipment that we use to test. And as Dr Mindy mentioned earlier, collecting over a million data points. Um, people are also asking, does insurance cover this? And this is considered CLR like LASIK is considered a Refractive surgery procedure.

[00:36:23] It is an option. It’s something that people do for themselves because they don’t want to wear glasses. So none of these are covered by insurance. Um, where LASIK is approximately 3, 000 per eye. This is approximately 7, 000 per eye. It’s going to become a little more for LAL. But right now, It’s 7, 000. Brian.

[00:36:43] We do offer financing. We can put this out over monthly payments over two years with no interest assessed. So a lot of patients will choose that because it just create creates affordability of the payments. So we’re able to do that. Um, but we’ve done the analysis and we share with patients that making this type of investment while significant is actually less expensive in the long run than continuing to buy glasses and contacts.

[00:37:07] And And Renee, you know, how much were you spending every year on your, uh, on all the glasses and things that you were wearing? Well, that would be a lot, uh, well over a thousand dollars a year, um, that has been documented. Um, and yeah, so that is, uh, that’s an expense I’m happy not to, I love going to the store and getting off the rack sunglasses.

[00:37:30] I think that’s a hoot. It’s great. And you know, some people say, Hey, I do have insurance that might cover part of this. And we do have a third party, uh, that we can refer you to that will do all that work for you. They will actually charge you a fee, a small percentage of anything they can get on your behalf.

[00:37:47] So we’ll be glad to connect you with them if that’s something that’s of interest. But patients do pay us directly for the services prior to having their procedure. Um, Dr Bindi, I wanted to share again on the screen something that you had mentioned, which was the, uh, Uh, way people can schedule a consultation.

[00:38:03] This is right on our website. We also invite people just, uh, they can either book a consultation online or they can call us at our number there and we’re happy. We have a great team of communication specialists that will answer questions and get you into the right type of consultation. But as we kind of wrap up things here, Dr Bandy, because we like to keep things to 40, 45 minutes and respect people’s time.

[00:38:25] Um, You know, you’ve been doing this a while. I mean, your entire career has been dedicated to being a outstanding refractive surgeon. You’re one of the few in the country who has specialized in this your entire career. Dr. Ling and Dr. Kochik now doing the same. Why do patients come to us? Well, I mean, it’s, it’s, it’s interesting.

[00:38:45] I mean, I, uh, even though the technology has evolved and procedures have evolved, um, what really hasn’t changed is the philosophy of what we’re trying to accomplish here. And, um, this, this is, this is a safety first kind of a thing. You know, I never, I never forget what we’re here to do. We’re here to help people see better.

[00:39:04] We want their lives to be better. We want them to wake up and see, well, it works out about 20 percent of the time. It’s better to not do a surgery. So I think the philosophy is. Let’s be careful first, make sure it’s okay. And it’s appropriate. And for the 80 percent of people are candidates, they can do it if they want to.

[00:39:19] And we’ll just get them from point A to point B and in the most appropriate way. Um, it’s, it’s fun. This is what we specialize in. We don’t do a lot of other things that general eye doctors do. You know, we don’t do retinal detachment surgery and we don’t do teeth whitening and weight loss. We do, we get people out of glasses.

[00:39:37] And so that’s, that’s what we specialize in. And for people who are good candidates, we can knock it out of the park. And Dr. Ling now and the thousands of patients that you’ve helped, uh, and many more over that you’re going to help over your career, you know, why do you like, why do you enjoy doing this so much?

[00:39:53] Because you could have been any, you could have been any kind of doctor you wanted to, and you know, your mom shared the story how she thought you were going to become an orthopedic surgeon when you were younger, but you became an eye surgeon. Why do you, why do you like this so much? Well, you know, all I had to do was, uh, shadow an ophthalmologist just that one time and see them do cataract surgery lens replacement to see how elegant and amazing a procedure it is and the result the next day.

[00:40:21] The amount of dramatic improvement to a patient’s life for a lens replacement procedure is unparalleled. compared to almost anything you can have in medicine. This is the most exciting field to be in and I take great pleasure in interacting with my patients. I love doing surgery, absolutely, but also just like seeing, you know, how well they do afterwards.

[00:40:43] That brings me, that’s what keeps me going. And, um, and, you know, the, the reputation of this practice at Dr. Bindi has been an amazing steward of and has really, you know, created an atmosphere of collegiality and, you know, goal to improve patients lives. And I really look forward to continuing carrying that.

[00:41:04] And, you know, we routinely survey our patients after they have a consultation with us. And the feedback that we get consistently is that the doctors. were honest. They were kind. The entire staff was very not just polite, but really caring. And that’s something that is very important to all of us here. We want the experience for all of you coming in and interacting with us, whether you have a procedure or not, because sometimes you’re not qualified for it to be one that is just excellent and outstanding.

[00:41:31] Um, and so I want to because I’m getting some questions about The, uh, the fee the fees and the increase. And so I just want to clarify, uh, October one. We are going to be increasing our fee for the light adjustable lens because it is a very, very expensive procedure to perform. There are multiple post operative visits for the adjustments.

[00:41:50] So that’s going to be going up. But any of you that are on the webinar, if you schedule your consultation with us, we’ll know who you are. We’ll know you were here. We’re going to honor the current pricing for that. So I just encourage you to. Uh, go to the website or give us a call and let us, uh, let us take care of you, uh, uh, in that manner and to see if you are a candidate for CLR or for one of our other procedures, if that’s not appropriate.

[00:42:13] And there’s our phone number up on the screen. There’s our website. If you have any questions that you didn’t ask on the webinar, ’cause you do ask them. And as if you’re, unless you’re said anonymous, if we have your name and your email, we will answer those questions over the next few days. Just give us a little time to make sure we can get through it, but.

[00:42:29] If you didn’t get it. If you didn’t have a chance to write it in, you can just send us an email at C. L. R. 2020. I site s i t dot com and we’ll be glad to take care of you. And with that, I want to thank you, Dr Bindi. I want to thank you, Dr Lang. I want to thank you, Renee for what you did. And I want to thank everyone who spent 45 minutes on a Friday early afternoon with us.

[00:42:48] We just wish you the best. Have a wonderful day. Wonderful weekend. And here’s to you achieving great vision. Thank you so much. Thank you, everybody. And 45 minutes, Sharif. Nice work. I’m impressed. Happy Friday. Bye bye.