Q: Who can have LASIK?  
A: There are a number of factors to consider before undergoing LASIK.
    Preliminary qualifications are:

• You should be at least 18 years old (21 for some lasers);
  
• You should not be pregnant or nursing;
  
• You should not be on certain prescriptions such as Accutane or steroids;
  
• Your eyes must be healthy with no signs of pre-existing disease;
  
• Your glasses prescription must be stable, unchanged for at least one year;
  
• You should be in good general health. The advisability of undergoing LASIK should be made on an individual basis for patients with diabetes, rheumatoid arthritis or lupus; and finally,
  
• LASIK candidates should have realistic expectations for their vision following surgery. Each individual should carefully weigh the risks and rewards.

Q: What is myopia or nearsightedness?  
A: If you are nearsighted, you cannot see things clearly in the distance. Objects seem fuzzy, muddled and/or blurry. As light enters the eye’s cornea (clear front portion of the eye), it travels through the lens where it is focused on the retina (back portion of the eye). In the myopic, or nearsighted eye, light rays are focused in front of the retina because the eye is too long. In order to correct this condition, the cornea must be made less steep or flatter, thus causing light to be focused on the retina.

Q: What is farsightedness?  
A: People who are farsighted (hyperopia) can see far away but have difficulty seeing up close. This causes difficulty reading or doing close work. In the hyperopic eye, images converge and are focused behind the retina because the eye is too short. In order to correct this condition, the cornea must be lengthened or made more steep.

Q: What is astigmatism?  
A: Imagine the shape of a football and the shape of a baseball. The astigmatic eye is shaped more like a football with “hills and valleys” than a smooth, spherical baseball. The astigmatic cornea is oblong in front, thus causing light to converge in two or more focal points and images appear double, ghosted, and/or blurry.

Q: How does LASIK work?  
A: Simply, Dr. Clement reshapes the cornea to reduce or eliminate nearsightedness, farsightedness and/or astigmatism using the highly precise excimer laser. This enables the vast majority of patients to see to drive, work, swim, play sports or just see the alarm clock in the morning without glasses or contact lenses. At Carolinas Eye Center, 98% of our patients see 20/20 or better after surgery!

Q: Can LASIK get rid of my reading glasses?  
A: The short answer is “yes,” but must be qualified by stating that the procedure is called monovision and is not used to correct nearsightedness, farsightedness or astigmatism. LASIK cannot correct presbyopia so that one eye sees both distance and near like bifocals. Dr. Clement offers monovision, or correcting one eye for distance vision and the other eye for near vision. This procedure may eliminate or reduce your need for reading glasses and/or bifocals. In some instances, surgery on only one eye is required. You may be fitted with a temporary contact lens to emulate monovision before choosing to undergo the procedure.

Q: Is LASIK painful?  
A: No, the application of anesthetic eye drops prior to surgery will make you comfortable. Once you return home after LASIK, it is normal for some patients to experience slight irritation, light sensitivity, or watery eyes. Most symptoms are relieved with over-the-counter pain medication.

Q: How long will I need to take off work?  
A: Most patients are able to see some results immediately. Your vision will be somewhat hazy initially, and then begin to clear over the next several days. Most people are back at work the next day. Each person does respond differently, however, partly depending on their age and prescription. You should be back to normal activities quickly.

Q: Are there risks with LASIK surgery?  
A: As with any surgical procedure, there are some risks associated with LASIK; however, LASIK is an extremely effective and safe procedure. LASIK is FDA-approved. It should be noted that each person does heal and respond differently. Dr. Clement and his staff are happy to talk with patients about the risks, benefits, and alternatives.

Q: What about dry eyes and poor night vision complications?  
A: Some people experience dry eyes as a result of LASIK. This can be treated quite effectively with supplemental tears (preservative-free) or punctual plugs. Prior to your procedure, Dr. Clement can measure your tear function to determine if your eyes are dry. With regard to poor night vision, the newest generations of lasers like the VISX and Technolas 217z can perform larger area treatments to decrease night glare and vision problems in patients with large pupils. Custom vision treatments can help correct spherical aberration, often the cause of poor night vision.

Q: Will LASIK last forever?  
A: The results typically last a lifetime, but a few patients can regress or need a second treatment (enhancement) to restore their best vision. Enhancements are typically performed within the first year. Undergoing LASIK will not prevent presbyopia (the need for reading glasses later in life). Patients undergoing monovision LASIK (one eye corrected for distance, the other for near), may eliminate their need for reading glasses and/or bifocals.

Q: What is the difference between PRK and LASIK?  
A: PRK, now referred to as surface ablation, is the original method in which laser vision correction was performed. The epithelial tissue is removed and the excimer laser is used on the anterior surface of the cornea to re-shape it. The recovery or re-growth of the epithelial tissue causes a slower recovery, but the final outcome is essentially the same as LASIK. In performing LASIK, Dr. Clement carefully uses a special instrument called a Microkeratome to create a flap which is left attached on one side and folded back while the epithelium is left intact. The excimer laser is then used to remove exceedingly thin layers of the cornea based on pre-operative calculations. The flap is then replaced without the need for stitches, and recovery begins.

Q: What is included in my pre-operative examination?  
A: You should be out of your contacts for a least one week before this examination as contacts can alter the natural shape of the cornea. Your dilated eye examination is done to determine a number of factors: the health of your eyes, the amount of correction needed, pupil size, corneal thickness, slit-lamp examination of the anterior segment of the eye, wavefront determination of higher-order aberrations, and a fundus exam to rule-out any diseases or deformities of the eye. Various diagnostic procedures and measurements will be done, and this information will later be entered into a computer in order to maximize your excimer laser correction and post-operative results.

An informed consent packet will be given to you outlining the possible risks and complications. You will have an opportunity to ask Dr. Clement or his staff any questions you may have or discuss any concerns.

Q: How long will the LASIK procedure take?   
A: Typically, LASIK takes only a very few minutes and is an out-patient procedure done in our office. You should plan to be with us about 1-1.5 hours so numbing eye drops can be administered prior to the procedure, and you can rest with us for 15-20 minutes after your procedure. We also may ask you to stop wearing makeup, lotions or perfume for a few days before surgery. These products can interfere with the laser treatment or increase the risk of infection after surgery.

Q: What happens during LASIK?   
A: When the numbing drops have been given an appropriate amount of time and Dr. Clement is ready for you, you will be escorted to the laser surgical suite. You will lie on the table with the laser above your eye. Your eye will be immobilized, and Dr. Clement will begin the procedure by using a special instrument called a microkeratome to create a very small flap out of corneal tissue. The flap is left attached on one side and folded back. Dr. Clement then uses the excimer laser, which has been preprogrammed with measurements obtained during your examination, to remove microscopic amounts of corneal tissue and thus, cause the cornea to flatten. Dr. Clement then replaces the flap into its natural position where it re-attaches to the eye without the need for sutures. You procedure is now complete, and you will then be escorted out of the surgical suite. You will be asked to remain with us for 15-20 minutes, and then you may leave.

Q: When will my vision start to improve?   
A: Most people notice a small improvement almost immediately; although some say vision is blurry the day of surgery but largely improves the next day. You should not drive until you feel comfortable with your new vision.

Q: Will my eye hurt after surgery?   
A: You may experience some slight burning, or a sensation that “something” is in your eye. You may take over-the-counter pain relievers to relieve any discomfort. Any excessive pain or unusual side effects should be reported to us immediately.
You are cautioned NOT to rub your eye(s)!

Q: When can I return to work?   
A: Most patients return the next day, while others take a few days off. You will also have your first follow-up examination with us the day after surgery.

Q: What are lower order and higher order aberrations?   
A: It is now possible to utilize wavefront technology to record detailed information about the visual characteristics of the eye. Unlike more standard measuring devices such as corneal topography, which measure the front surface of the eye (cornea), the wavefront maps the entire optical system as it processes a beam of light. As a group, myopia (nearsightedness), hyperopia (farsightedness), and astigmatism are referred to as “lower order” aberrations, and are responsible for 90-92% of the distortions in vision people experience The remaining 8-10% of the visual blur falls outside this group of lower order aberrations, and cannot be corrected by glasses. Hence, this group is referred to as “higher order” aberrations. In just the past 1-2 years, surgeons now have the ability to correct higher order aberrations. Dr. Clement can measure and correct these aberrations using wavefront-guided laser treatment which, when combined with correction for lower order aberrations, has the potential to produce near perfect vision.

Q: How does wavefront work?  
A: Wavefront analysis is like taking a “fingerprint” of the eye. Each individual’s wavefront scan will be different. Basically, wavefront works by measuring the distortion or irregularities of the eye known as higher-order aberrations. When a ray of light first enters the eye, it passes through the cornea to the lens and vitreous (clear jelly-like substance inside the eye), ultimately reaching the retina. As it bounces off the retina and returns back through the cornea, the wavefront analysis detects and documents distortions which are unique to each individual.

Q: What is custom LASIK?  
A: Through the collection of wavefront data, Dr. Clement can determine what adjustments must be made to the corneal surface to produce a clear, crisp image for the unique visual needs of each patient. Wavefront data results in a set of very precise measurements to correct the higher-order visual aberrations. The use of wavefront technology to provide more precise laser vision correction is known as custom LASIK or wavefront-driven LASIK.

Q: How do I get started?  
A: Now that’s easy! Simply call call us at 866-290-3937 or in the local Charlotte area at 704-510-3100 to schedule a free screening, or you may contact us online. Your initial screening will be free; however, a regular, more detailed examination will need to be scheduled and fees for the examination will be deducted from the cost of your procedure.