Questions About LASIK

The following information answers question that we frequently hear from our patients about LASIK, however, these questions also apply to PRK and Zyoptix Customized Lasik. For more information, please contact us.

Who is a good candidate for LASIK eye surgery?
LASIK candidates are nearsighted (myopic) or farsighted (hyperopic) and may have astigmatism. Additionally, a suitable LASIK candidate will have a stable vision prescription for approximately one year and good overall eye health. There is no maximum age for having LASIK, however, a candidate must be at least 18 years of age (and preferably 21) so that the eyes - and vision - will have matured sufficiently.

During your initial consultation, one of our doctors will evaluate your eye health and your vision to determine if LASIK is right for you. For most patients, LASIK will correct their vision, however, if LASIK isn't right for you, one of our other vision correction options may be available.

What is "monovision LASIK"?  Is it a good option for people who wear bi-focal contacts or glasses?

The simple answer to this question is "maybe".

Although LASIK, PRK and Zyoptix can and achieve perfect vision, you still will develop a condition called presbyopia typically between the ages of 40 and 50. Presbyopia is the inability of the eye to focus at all distances, usually noticed when fine print starts to blur.  Presbyopia is said to be caused by the hardening and thickening of the natural lens of the eye (crystalline lens), which is located inside the eye.

Normally, both your eyes work together equally when you look at an object, to produce what's called binocular vision. However, you probably have a dominant eye that your brain tends to favor (most right-handed people are right-eye dominant, for example). Contact lens fitters often take advantage of this "one-eye dominance" to produce monovision.  Using contact lenses, they fit one eye for distance vision (typically the dominant eye) and one for near vision.    Therefore, in monovision, one eye does more work  than the other. If one of your eyes is set for distance vision and the other is set for near vision, the distance eye will do most of the work when looking at objects in the distance, and the near vision eye will do most of the work when looking at objects close by.

Some LASIK surgeons will produce monovision in their presbyopic patients by purposely leaving the non-dominant eye slightly nearsighted so that these patients can see up close without glasses. This is usually demonstrated in our office during your initial exam,  because not everyone can become accustomed to the absence of binocular vision.

How long does a LASIK procedure take?
The time for the actual laser treatment is typically less than one minute. Most patients will be in the laser suite for a total of 15-20 minutes. You should plan to be in the laser center for approximately an hour. Even though the procedure itself is fast, we avoid rushing the patients in and out, and like to take plenty of time with each of them. Although we welcome our patients to have a friend or family member join them during the post-operative instructions given prior to surgery, we can only allow our surgical team in the room during surgery.

Is LASIK painful?
No. Your LASIK eye surgery will not be painful. Throughout the entire LASIK procedure, your eyes will be numbed so that you will not feel any discomfort. In order to prevent you from blinking during the procedure, your eye will be held open with a special instrument called a speculum. The actual laser vision correction takes less than one minute per eye, and you will not feel any pain.

After the procedure, some patients experience slight discomfort, but this can be corrected with over-the-counter pain medications. Usually, any discomfort goes away after a few hours.

Will I have both eyes treated on the same day?
Yes, many of our LASIK patients choose to have both of their eyes corrected at the same time. However, if you choose to, you can have one eye treated at a time.

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Is the procedure done under anesthesia?
Yes. Prior to surgery, the eye is anesthetized with eye drops. The anesthetic used is the same powerful eye drops used during cataract surgery, which is far more invasive than LASIK. As a result, there is no pain during the surgery. Approximately 1-3 hours after the surgery, you may experience mild tearing or a foreign body sensation, like an eyelash or a new contact lens in your eye. This sensation disappears after sleeping and a topical eyedrop called Acular is supplied by Clear Advantage to be used after surgery, if needed.

How soon can I go back to work?
Although you will be able to see immediately after surgery, our surgical team will instruct you to go home and "rest" your eyes. A mild sedative, such as Valium, will be prescribed for those who are nervous about the procedure or need assistance in taking a nap afterwards. After returning to Clear Advantage for a quick 1-day follow up exam, most patients return to work the day after surgery.

How often do I need to return to Clear Advantage for my follow up care?
Follow up appointments are critical in monitoring your progress after surgery. Although a large majority of our patients do not have any complications after surgery and are enjoying their lives without contact lenses or glasses, it is imperative that you are seen on a regular basis after surgery. You follow up appointments will be as follows:

• Surgery Day
• The day after surgery (1-day follow up)
• One week after surgery
• One month after surgery
• Three months after surgery
• One year after surgery

Can I see my regular doctor for my follow up visits?
We work closely with a number of optometrists in the surrounding area. If traveling to our office for follow up appointments is an issue, we may be able to find a doctor in your area that is willing to provide your follow up care at no additional charge to you.

What are the most common side effects of laser vision correction?
A small number of patients have reported fluctuating vision, night glare, and dry eyes during the first few weeks after LASIK. However, these side-effects are greatly reduced with our advanced screening and treatment technology, such as the Orbscan. For example, we measure the size of your pupils and the thickness of your cornea to prevent night vision problems. Zyoptix customized LASIK also reduces the likelihood of glare and halos at night for those with larger pupils or more significant prescriptions.

Will I still need glasses after my LASIK procedure?
For most patients, LASIK vision correction corrects their refractive errors so much, that they no longer require the use of their eyeglasses or contacts. However, the need for reading glasses occurs naturally in most people in their early 40's whether they are nearsighted, farsighted or normal. Laser vision correction can be calibrated to avoid reading glasses after 40 if one eye is kept slightly nearsighted - this is called monovision LASIK.

Is LASIK permanent?
Yes, the laser permanently etches the correct shape to your cornea. In patients with a correction higher than 6 diopters, however, the effect of the procedure may diminish slightly, typically within the first year - a phenomenon called "regression". This is generally corrected through an enhancement, which is done 3 months or more after your original LASIK procedure.

What is an enhancement?
LASIK enhancement takes place following a LASIK procedure and is designed to "fine-tune" the patient's vision. Clear Advantage does not charge for a LASIK enhancement as it is generally included as part of the original LASIK surgery price. A LASIK enhancement is rarely required, with most patients content with the outcome of the original procedure.

Dr. Peter's overall enhancement rate is 1.2%, an extremely small number considering the national average is between 8% and 10%.

When do you decide about a possible enhancement?
Because your vision will adjust itself and will keep improving in the first few months after the procedure, enhancements are usually performed within 3-9 months. They tend to be faster than the original procedure, because there is no need to create a new flap, and because the amount of treatment is minimal.

If you live in the Portsmouth or Seacoast area and would like to learn more about your LASIK surgery options, contact Clear Advantage.  During your initial consultation, we will help you determine if LASIK is right for you.