Cutting Eyeballs in the Window

By Silissa Kenney

Passersby look in on a live surgery at Park Avenue Laser Vision on East 25th St.
Photograph by Remi Hu
     Passersby look in on a live surgery at Park Avenue Laser Vision
on East 25th St.

Imagine that you’re walking down the street and come across live surgery being performed in an office window. It looks so easy and painless, you decide to get the surgery yourself. Sound unlikely?

At Park Avenue Laser Vision on East 25th Street, Dr. Emil William Chynn performs Lasek with only a sheet of glass separating the operating room from the sidewalk. “We’re always doing new things here,” says Dr. Chynn.

Lasek (laser epithelial keratomileusi) is a vision-correcting surgery similar to the better-known Lasik (laser in situ keratomileusi). Both surgeries aim to reshape the cornea, the outer layer of the eye. In Lasik, a flap in the cornea is cut and the corneal tissue is reshaped, then the flap is replaced; in Lasek, no flap is cut, and the outer layer of the cornea, the epithelium, is peeled back using an alcohol solution, then replaced or removed. Lasek seeks to avoid the flap-related complications of Lasik, though it has its own complications, including dry eyes, incomplete or inaccurate vision correction and post-op infection.

Dr. Chynn, 44, earned a medical degree at Columbia, completed his residency at Harvard and also has an M.B.A. from New York University and has three patents. He spends a lot of time thinking up new ways to attract new patients.

“There are no returning customers here, so the better job we do, the less customers,” says Dr. Chynn, “so we keep needing to think about finding new customers.”

One day last month, Justo Cruz, 25, lay in what looks like a dentist chair, about to undergo the surgery. Gripping a blue stress ball in his right hand, he was noticeably nervous. At his side was his wife, Arlene, offering words of encouragement to go along with the Valium he had been given to ease anxiety.

“You’re gonna be able to see Lexus clear and perfect!” says Arlene Cruz to her husband referring to their daughter.

Justo Cruz resting after surgery while his wife, Arlene, lends support.
Photograph by Silissa Kenney
     Justo Cruz resting after surgery while his wife, Arlene, lends support.

Dr. Chynn aims to gain patients by making use of the Internet, discounts and testimonials. Even his employees are walking advertisements. Nearly all of Dr. Chynn’s staff have had Lasik or Lasek.

Patrick Bailey, a patient coordinator at Park Avenue Laser, has had Lasek himself.

“Sometimes when you’re selling something, a testimonial can go a long way to building trust,” says Bailey.

Bailey even pitches the practice at the bus stop. When fellow commuters noticed that he could see two blocks down the road, he handed out his card. “We could probably do something for you, too,” he told them.

Bailey estimates that about a third of new patients are drawn in by the Web site (, which has a blog; links to media coverage by Fox News, ABC News, The New York Times and others, and a “virtual laser simulator” so patients can practice what it will be like on surgery day.

Park Avenue Laser also has Facebook page, though to date it has only nine “fans,” and a Twitter account — where the staff is encouraged to post individually once a day — with 27 followers. On Oct. 15, the front desk manager posted, “If you can guess what I ordered from Shake Shack for lunch, I’ll give you a $100 discount!”

Dr. Chynn offers a number of discounts, including for referring a friend and a corporate or group discount if friends come together for surgery. It’s the discount he offers if patients post their surgery on YouTube that has received some attention — and some criticism.

“It’s disappointing to see commercialism creeping into what should be a very altruistic profession,” Ruth Fischbach, a bioethics professor and the director of the Center for Bioethics at Columbia University, told The New York Times in an article that Park Avenue Laser has posted on its site.

Cutting Eyeballs in the Window
Photograph by Remi Hu

And Alison Preszler, a spokesperson for the Better Business Bureau, in the same article expressed concern about the effect on consumers. “With paid testimonials you’re running the risk that the consumer’s opinion was skewed by dollar signs, and isn’t necessarily telling the truth,” she said.

Dr. Chynn doesn’t think there is any ethical problem. The discount is only $100 on a surgery that might cost $5,000, he says, and the payment is just a way to compensate people for the time and energy it takes to post the surgery on the Internet.

For his videos, a camera is attached to the laser, so the eyeball is the star. The video, says Dr. Chynn, is just a way for people to see exactly what happens during surgery and to provide visual understanding of how Lasek differs from Lasik. He estimates that around 5 percent of his patients agree to post their surgery online.

Seeing a surgery can be more powerful than just hearing about it, which is where the ideas to perform the procedure in the window and to post videos come in. Dr. Chynn also tries to get people through the door by offering free seminars, inviting people to be in the O.R. during a surgery and having events. Before Halloween, the Twitter account was buzzing with invitations to a Halloween party and to watch surgery. “Best costume gets a special offer!” announced the Twitter post. On Nov. 24, he’ll hold an early Thanksgiving event complete with refreshments and live surgery.

Once potential patients show interest, getting them to commit is the goal, and the whole staff is schooled on how to best ensure that a patient decides to have the procedure. At an early-morning marketing meeting, Dr. Chynn delivers a pep talk.

“If you have chatty patient who speaks well and is enthusiastic, ask him to email … so we can put them up on the blog,” Dr. Chynn tells the staff. Or if an email from a patient might be informative, that should go on the blog too, “even if it’s a patient problem,” he says.

Cutting Eyeballs in the Window
Photograph by Remi Hu

Dr. Chynn tells the staff that every time they see Adam Weiss, hired to do public relations for the practice, they are to present a sales dilemma they had in the last week so that Weiss can instruct them on what they might have done better. Knowing about a potential patient—what her worries are, what other practice they might be considering—is vital, says Dr. Chynn.

“I like to use a dating analogy,” says Dr.Chynn. “You like a guy and you want to date him, but there is another girl involved. What are you going to find out about her? Everything. You have to know your competition.”

Lasik still dominates the vision-correction market, according to the 2008 survey by the American Academy of Ophthalmologists, “US Trends in Refractive Surgery.” Ninety-six percent of those surveyed now do, or plan to, perform Lasik, while the number is 30 percent for Lasek.

Though the overall economy is struggling to recover, Dr. Chynn says he hasn’t seen the volume of his business decline. And he has kept his advertising efforts constant throughout the economic downturn.

As Dr. Chynn leans over Cruz, people on the sidewalk do stop to watch.

“I saw the guy doing surgery and I was like, wow, it’s pretty amazing,” said Tim Petryri, 20, who stopped to watch, even though he doesn’t wear glasses or contacts. But even he is a possible avenue to new patients.

“If you meet anyone, tell them about us!” says a Park Avenue Laser employee standing outside with Petryri.

When the surgery is over — about two minutes for each eye — Cruz moves to a comfortable recliner outside the OR. The procedure was “a little stingy at first, but it goes away,” says Cruz, speaking with his eyes closed as per post-op instructions. “I didn’t even feel that he was touching my eyeball.”

He noticed an improvement in his vision immediately. “It felt like a miracle. I definitely recommend this place.”

Click here to watch video of a surgery.