Custom LASIK in Maryland, Virginia, Washington DC, and Surrounding Areas

The surgeons at Eye Doctors of Washington, Thomas E. Clinch, M.D., and Paul C. Kang, M.D., have been performing laser vision correction for over 10 years. They were involved in clinical trials that led to FDA approval of LASIK and PRK surgery. The doctors pride themselves on offering the finest LASIK eye surgery technologies, including CustomVue™ LASIK, or Wavefront™ LASIK. Both Drs. Clinch and Kang presently perform all-laser Custom LASIK for patients across Bethesda and Chevy Chase, Maryland, Northern Virginia, and the Washington DC area.

While they have performed over 20,000 LASIK vision correction procedures, Dr. Thomas E. Clinch and Dr. Paul C. Kang emphasize educating their patients about their treatment options and treating each patient’s visual needs individually to determine his or her unique goals and expectations. The practice is NOT solely a laser center. For that reason, you will get a balanced perspective on the pros and cons of LASIK eye surgery, IOL technologies, as well as non-surgical options such as the latest in contact lenses and glasses.

• Overview of LASIK
• History of LASIK
• Custom LASIK Today
• Preoperative Testing
• The Surgical Procedure
  • Creation of Corneal Flap with IntraLase®
  • Reshaping the Cornea with Wavefront™ Technology
  • Alternative to Wavefront™ LASIK
• Custom LASIK vs. Custom PRK

Overview of LASIK

LASIK eye surgery, performed by Thomas E. Clinch, M.D., and Paul C. Kang, M.D., is a quick, safe, and comfortable laser vision correction procedure. With CustomVue™ Custom LASIK and IntraLase® technologies, our patients are seeing better than ever! The LASIK procedure is done in our Chevy Chase, Maryland office and takes a few minutes per eye. Most patients drive themselves to their follow up visits the day after surgery and return to work that day as well. For a more detailed description of LASIK eye surgery, please see the sections below.

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History of LASIK

In the 1980s, IBM pioneered the precise excimer laser technology to improve semiconductor capacity. An unexpected benefit was that the specific ultraviolet wavelength emitted by the excimer laser was ideal for reshaping corneal tissue with submicron precision.

By changing the shape of the corneal surface, the excimer laser is used to correct refractive errors such as nearsightedness, farsightedness, and astigmatism. Excimer lasers first entered FDA clinical trials in the late 1980s. In the original clinical trials, the lasers were only used on the surface of the eye in a procedure called PRK. While PRK had excellent results and is still performed today, removal of the surface cells of the cornea creates discomfort and several days of blurry vision. In subsequent trials, the excimer lasers were used to perform LASIK eye surgery, in which the corneal laser treatment was placed beneath a corneal flap. Since the surface of the eye is not disturbed, the speed of recovery is much more rapid with minimal discomfort.

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Custom LASIK Today

Custom LASIK (Laser In Situ Keratomileusis) has become the most common vision correction procedure performed in the United States. The acceptance of Custom LASIK by patients and eye care professionals is due to rapid visual recovery, excellent visual results, and increased safety. When performed by Thomas E. Clinch, M.D. and Paul C. Kang, M.D., the Custom LASIK procedure for both eyes takes approximately 15 minutes!

CustomVue™ and Wavefront™ LASIK today allows our doctors to correct an individual’s unique refractive error, achieving results that are better than those attained with glasses or contacts. Almost everyone has a friend, colleague, or family member that has benefited from this extraordinary procedure. Patients are always amazed by the speed and comfort of Custom LASIK eye surgery. Several of our Maryland, Virginia, and DC area doctors, including Dr. Clinch, have had the procedure performed on their eyes. Because of this, Dr. Clinch has a unique perspective as both a patient and LASIK surgeon.

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Preoperative Testing

At Eye Doctors of Washington, Drs. Clinch and Kang offer complimentary consultations to determine your candidacy for Custom LASIK or alternative vision correction procedures. These consultations can be performed at either our Maryland (Chevy Chase) or Washington, DC (16th St.) office. Both locations are convenient to Northern Virginia and Bethesda area patients. The consultations generally last about one hour. Your eyes will not be dilated and you do not need to discontinue wearing your contact lenses before this appointment.

Once our doctors determine that you are a good candidate for Custom LASIK or an alternative eye surgery, you will schedule a preoperative exam in our Chevy Chase, Maryland office. During this exam, your eyes will be dilated and our technicians will perform an array of diagnostic tests to gather all the data they need to develop the best possible surgical treatment plan.

Please Note: If you are a contact lens wearer, you must refrain from wearing contact lenses before this exam:

• Soft lenses - 1 week before your exam
• Toric lenses - 2 weeks before your exam
• Hard or gas permeable lenses – 3 weeks for every decade of wear

Eye Doctors of Washington uses the Oculus Pentacam, the most advanced corneal analysis system available, to make certain that your cornea is appropriate for laser eye surgery. The Pentacam images the anterior segment of the eye with rotating Scheimpflug camera measurements. This rotating process supplies pictures in three dimensions. The measurement process lasts less than four seconds and measures 25,000 true elevation points. This precise representation has increased the safety and precision of the LASIK procedure.

Once you have completed your preoperative exam, you can have Custom LASIK eye surgery as soon as the following week! For our patients in Bethesda, Northern Virginia, and across Maryland and the Washington DC area, we ask that you arrive 30 minutes before your scheduled procedure, and you should anticipate being in our office for an hour and a half.

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Wavefront™ LASIK Surgery

To get you prepared for Custom Wavefront™ LASIK surgery on the day of your procedure, a technician will bring you into an exam room. They will review the procedure and the postoperative instructions. Valium will be dispensed to reduce any anxiety about the pending procedure. The technician will then prepare your eyes by cleaning your eyelids and instilling a series of drops.

When your name is called by the surgical technician, you will be brought into the laser suite. With your permission, family or friends may view the Custom LASIK procedure through the window. The technician will settle you in the comfortable reclining surgical chair.

Custom Wavefront™ LASIK involves two steps: the creation of a corneal flap followed by the reshaping the cornea with the excimer laser.

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Creation of the Corneal Flap using IntraLase®

Drs. Clinch and Kang solely use the all-laser, all-computerized IntraLase® femtosecond laser to create the corneal flap. IntraLase® uses a beam of light to place thousands of bubbles in the central layer of your cornea. These bubbles expand to create a space between the corneal flap and the rest of the cornea, allowing the surgeon to easily lift the flap during the Custom LASIK procedure without using a blade. According to comparative studies, patients report better visual outcomes with the IntraLase® method than alternative methods of creating the corneal flap. Our surgeons recommend the IntraLase® laser for all of our patients because it provides superior precision and safety.

Our surgeons recommend the IntraLase® laser for all of our Custom LASIK patients for the following reasons:

• Precision: The IntraLase® creates a precise flap of predetermined thickness and size.
• Safety: The flap is created with bubbles rather than a blade so the formation of an irregular flap is exceedingly rare.
• Outcomes: Comparative studies, including one by the U.S. Navy on fighter pilots, confirm that patients see better following laser eye surgery with IntraLase® than with previous methods!

For many years, the mechanical microkeratome was the only option to create the laser flap. While the overall results with a microkeratome were good, the flap size and thickness could not be precisely controlled. Despite proper placement by the surgeon and good patient cooperation, the microkeratome occasionally created a flap that was irregular in size or thickness. These irregular flaps required the surgeon to postpone the procedure for 3-6 months and created permanent visual distortions. View Microkeratome Animation

View Microkeratome Animation

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Reshaping the Cornea using Wavefront™ LASIK Technology

During your preoperative exam, the WaveScan™ is used to map out the unique characteristics or higher order aberrations of your cornea 25 times more precisely than the method used to obtain your eye glasses prescription. The map is so detailed that it is likened to a fingerprint of your cornea.

On the day of the procedure, the data from the WaveScan™ is inserted into the laser with your unique CustomVue™ treatment. Reducing or eliminating higher order aberrations has improved the outcomes of the LASIK eye surgery procedure. In fact, 98 percent of patients who participated in the CustomVue™ clinical trials saw 20/20 or better at their three month visit following surgery. Dr. Clinch had CustomVue™ IntraLase® LASIK and now sees 20/15 (better than 20/20)!

During CustomVue™ LASIK surgery, your job is simply to look at the red light. Many patients are anxious that moving during the procedure will impair the results. While it is important to stay as still as possible, there are many safety features built into the laser to improve the treatment:

1. The VISX CustomVue™ Wavefront™ laser tracks the movements of your eyes 200 times per second during the Custom LASIK procedure. If your eye moves outside of the range that the laser can track, the laser will simply shut off. When your eyes are again centered, the laser will pick up where it left off and continue your treatment.

2. Some patients wonder how they will keep their eyes open during the entire procedure without blinking. The good news is that you don't have to. During Custom LASIK surgery, an instrument is used to keep your eyelids open for you.

3. The actual critical time that the laser is doing the treatment usually lasts between 30 and 60 seconds!

When your Custom LASIK surgery is complete, your surgeon will wait several minutes to assure that the corneal flap is secure. Once the flap is in position, you can blink normally. You will be escorted out of the laser suite by a technician and your surgeon will take one more look at your eyes.

After this point, you will be free to go home. Be sure someone is present to take you home since you may be a little sleepy from the Valium and blurry from the procedure. We do ask that you go straight home and keep your eyes closed for a few hours to help speed the healing along. Be sure to begin using your post-operative drops as soon as you get home.

Note: We have provided post operative LASIK instructions online to assist with your recovery.

You will be seen the day after your Custom LASIK procedure as well as at 1-2 weeks, one month, and three months. At that point, most patients are told to simply return for annual exams.

Not all patients are candidates for CustomVue™ Custom LASIK. Our Maryland and Virginia-area LASIK surgeons will discuss the options available to you based on your vision needs and goals.

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Alternative to Wavefront™ LASIK

The alternative to CustomVue™ LASIK is standard or traditional LASIK, also offered to our Maryland, Northern Virginia, and Washington DC area patients. In the standard LASIK procedure, a patient's glasses or contact lens prescription is plugged into the laser, and the laser simply corrects that patient’s degree of nearsightedness, farsightedness, or astigmatism. Custom LASIK, however, can enhance vision by correcting unique refractive errors known as higher order aberrations for the best possible results.

To find out if you can benefit from Custom LASIK, also known as CustomVue™ or Wavefront™ LASIK, contact our practice, serving Maryland, Northern Virginia and surrounding areas, to schedule a consultation with Dr. Clinch or Dr. Kang.

Custom LASIK vs. Custom PRK

While most people who are interested in laser vision correction are good candidates for Custom LASIK, some people are not due to certain circumstances. If you have thin corneas, dry eyes, an unusually, or are in the military, PRK may be better suited to your visual needs.

PRK was approved by the FDA in 1995 for the treatment of nearsightedness, farsightedness, and astigmatism. The PRK procedure is painless. Local anesthetic drops are placed on the eye to remove any sensation. Then, the outer cells of the cornea or epithelium are removed to expose the underlying cells. The VISX STAR S4 laser uses CustomVue™ technology to reshape the cornea in a procedure that usually takes less than one minute. Once the procedure is complete, a bandage contact lens is placed on the eye to facilitate healing and to reduce discomfort. The lens is left on the eye for several days until the epithelial cells have healed.

To find out if you can benefit from PRK or Custom Wavefront™ LASIK with IntraLase®, contact Eye Doctors of Washington, serving Bethesda, Maryland, Washington DC, and Northern Virginia areas.