Best Practices: Park Avenue LASEK
Dr. Emil Chynn on his family legacy, his journey to becoming an ophthalmologist, and what makes his practice unique.
The Park Avenue office of ophthalmologist Emil Chynn MD, FACS, MBA is the only center in the tri-state area performing only LASEK, an alternative to LASIK that foregoes cutting of the cornea altogether and therefore eliminates the accompanying risks. The doctor practices what he preaches — he switched entirely to non-cutting LASEK 15 years ago, and hasn’t looked back since. Here, he talks to us about his approach, what sparked his early interest in eye surgery, and why he swears by an all-glass operating room.
I know you have some doctors in the family. Is that how you became interested in ophthalmology?
My whole family consists of physicians. I’m actually a third-generation ophthalmologist. My grandfather was the equivalent of the Surgeon General in Taiwan and also an ophthalmologist. My uncle is a retina surgeon at Harvard, which is where I did my residency. So our family legacy is one reason I went into ophthalmology. But another reason is that I had a really bad eyeglass prescription when I was a kid because I was an avid reader and had read about the first form of vision correction, RK, in a Time magazine article in the 1970s. RK is a procedure using a knife to make incisions into the cornea to flatten it. The article showed eye surgeons in Russia operating on patients using a rotating operating table, where each surgeon would perform one step. That really sparked my imagination.
Can you talk about LASIK vs LASEK, who is a candidate for each, and why there isn’t better branding on those names? They sound so similar!
LASEK is a non-cutting procedure that involves lasering the surface of the cornea to flatten it, thereby getting rid of the prescription. LASIK is a cutting procedure, where a flap is cut into the cornea, which is lifted up, and then the laser is applied under the flap (within the cornea rather than on the surface). Because LASEK is non-cutting, it is statistically safer than LASIK, and even has a better safety record than wearing contacts. LASEK has a longer recovery time than LASIK because the skin of the eye is removed and has to grow back. LASEK can safely treat most people who don’t qualify for LASIK: People, for example, with thin corneas or extreme prescriptions; people with dry eyes, since we’re not causing or exacerbating dry eye by cutting the corneal nerves; and people who can’t handle any night glare (drivers of various types), because when you don’t get a flap you don’t end up with a two-piece cornea, which invariably causes backscatter of light at the flap interface. There are about 10 reasons why the average person can get denied for LASIK, and we can fix about 90% of those people with LASEK.
How many Americans have had laser vision correction by now? How many are getting it each year?
About 10 million Americans have had some form of laser vision correction in the 30 years it has been around. Surgical volume fluctuates widely year to year. The peak volume was about 850,000 eyes in 2007, right before the recession, after which it went down to only about 250,000. Since then, the numbers have gone up every year, so now we are almost back up to the peak. However, we eye surgeons are doing a horrible job at educating the consumer that laser vision correction is safer and cheaper than a lifetime of contact lens wear, as every year, more people newly need glasses and contacts than are getting lasered. So the pool of candidates is actually increasing.
What about the glass operating room you have that looks out onto the street?
Because we eliminated the riskier flap-cutting step, we also cut out the possibility of a major complication, and so feel confident in having an all-glass operating room. It’s like the “open kitchen” concept, where a restaurant has to be confident that everything will be perfect, since the public can view the entire process. This also allows us to film “sit up and cry” videos for each patient, where they sit up after LASEK, open their eyes, and, in many cases, see clearly for the first time since they were children. People often literally cry. Last week we lasered a man who won two gold bracelets for the World Series of Poker, in which he won $3 million and then $7 million. His wife said she’s only see him cry 3 times in his life — after each WSOP win, and when he sat up after his LASEK. Having our all-glass OR allows this, as the emotion is triggered from the patient seeing the trees across the street clearly without glasses or contacts for the first time in decades. You can’t get that kind of emotion by having the patient read an eye chart after surgery!
Vital Signs
Best patient amenity? We offer both nitrous oxide (laughing gas) and a new FDA-approved ketamine lozenge in the OR, which makes it impossible to be nervous during your procedure. We’ve had kids in their 20s say that with these drugs, it is almost a “recreational experience” that they “enjoyed”!
Favorite recent success story? We did LASEK on a patient who flew in from China, because she couldn’t find a surgeon there with experience lasering her extreme prescription (-21.00). When she sat up after her LASEK she started to cry, and said, “I can see the leaves on the trees!” I said, “well, that’s nice.” She said, “No, you don’t understand — contacts only go up to -19.00, so I was still -2.00 in contacts. This is the first time in my life I have ever seen leaves on a tree!”
What you like to do to relax? Play with Tolstoy, my Russian wolfhound puppy, for whom I am throwing a 1st birthday party and closing a block in the West Village for that (he’s a bit spoiled)! We’ll have food, drink, and a doggie cake, of course.
Learn more about Park Avenue LASEK here!
Know an innovative practice in NYC? We’d love to hear, introduce us here!
