LASIK

Laser vision correction is one of the most frequently sought procedures in the U.S. From celebrities to the mainstream, hundreds of thousands of people who were tired of the hassle and expense of glasses or contact lenses and wanted to reduce, or eliminate, their dependence with laser vision correction, have had this safe and “magic-like” procedure.

Thousands upon thousands of people are choosing to experience life without glasses or contact lenses. From people in their late teens to early 20’s, to middle age, to mature adults, technology continues to evolve that meets the demand for glasses-free living. Whether you are nearsighted, farsighted, have astigmatism, or presbyopia, Carolinas Eye Center devotes itself exclusively to the art and science of refractive surgery. Dr. Wesley Clement, one of the area’s most experienced refractive surgeons, continues to be on the leading edge of offering the newest treatments supported by the latest equipment for patients who want today’s state-of-the-art technology.

One of the most popular excimer lasers used by Carolinas Eye Center is the VISX Star S4 Excimer Laser System. It has IR (Iris Registration) for more custom and accurate laser ablation. Time and time again performs accurately and precisely for laser-vision correction.

Candidates for Lasik are at least 18 years of age, have a stable glasses prescription and are free of eye disease. Status for candidacy for Lasik is typically determined during an initial evaluation by Dr. Clement.

What are the risk?

Most patients are very pleased with the results of their refractive surgery. However, like any other medical procedure, there are risks involved. That’s why it is important for you to understand the limitations and possible complications of refractive surgery.

Before undergoing a refractive procedure, you should carefully weigh the risks and benefits based on your own personal value system, and try to avoid being influenced by friends that have had the procedure or doctors encouraging you to do so.

  • Some patients lose vision. Some patients lose lines of vision on the vision chart      that cannot be corrected with glasses, contact lenses, or surgery as a      result of treatment.
  • Some patients develop debilitating visual symptoms. Some patients develop glare, halos, and/or double      vision that can seriously affect nighttime vision. Even with good vision      on the vision chart, some patients do not see as well in situations of low      contrast, such as at night or in fog, after treatment as compared to      before treatment.
  • You may be under treated or over treated. Only a certain percent of patients achieve 20/20      vision without glasses or contacts. You may require additional treatment,      but additional treatment may not be possible. You may still need glasses      or contact lenses after surgery. This may be true even if you only      required a very weak prescription before surgery. If you used reading      glasses before surgery, you may still need reading glasses after surgery.
  • Some patients may develop severe dry eye syndrome. As a result of surgery, your eye may not be able to      produce enough tears to keep the eye moist and comfortable. Dry eye not      only causes discomfort, but can reduce visual quality due to intermittent      blurring and other visual symptoms. This condition may be permanent.      Intensive drop therapy and use of plugs or other procedures may be      required.
  • Results are generally not as good in patients with very      large refractive errors of any type. You      should discuss your expectations with your doctor and realize that you may      still require glasses or contacts after the surgery.
  • For some farsighted patients, results may diminish with      age. If you are farsighted, the      level of improved vision you experience after surgery may decrease with      age. This can occur if your manifest refraction (a vision exam with lenses      before dilating drops) is very different from your cycloplegic refraction      (a vision exam with lenses after dilating drops).
  • Long-term data are not available. LASIK is a relatively new technology. The first laser      was approved for LASIK eye surgery in 1998. Therefore, the long-term      safety and effectiveness of LASIK surgery is not known.

Additional Risks if you are Considering the Following:

  • Monovision

Monovision is one clinical technique used to deal with the correction of presbyopia, the gradual loss of the ability of the eye to change focus for close-up tasks that progresses with age. The intent of monovision is for the presbyopic patient to use one eye for distance viewing and one eye for near viewing. This practice was first applied to fit contact lens wearers and more recently to LASIK and other refractive surgeries. With contact lenses, a presbyopic patient has one eye fit with a contact lens to correct distance vision, and the other eye fit with a contact lens to correct near vision. In the same way, with LASIK, a presbyopic patient has one eye operated on to correct the distance vision, and the other operated on to correct the near vision. In other words, the goal of the surgery is for one eye to have vision worse than 20/20, the commonly referred to goal for LASIK surgical correction of distance vision. Since one eye is corrected for distance viewing and the other eye is corrected for near viewing, the two eyes no longer work together. This results in poorer quality vision and a decrease in depth perception. These effects of monovision are most noticeable in low lighting conditions and when performing tasks requiring very sharp vision. Therefore, you may need to wear glasses or contact lenses to fully correct both eyes for distance or near when performing visually demanding tasks, such as driving at night, operating dangerous equipment, or performing occupational tasks requiring very sharp close vision (e.g., reading small print for long periods of time).

Many patients cannot get used to having one eye blurred at all times. Therefore, if you are considering monovision with LASIK, make sure you go through a trial period with contact lenses to see if you can tolerate monovision, before having the surgery performed on your eyes. Find out if you pass your state’s driver’s license requirements with monovision.

In addition, you should consider how much your presbyopia is expected to increase in the future. Ask your doctor when you should expect the results of your monovision surgery to no longer be enough for you to see near-by objects clearly without the aid of glasses or contacts, or when a second surgery might be required to further correct your near vision.

  • Bilateral Simultaneous Treatment

You may choose to have LASIK surgery on both eyes at the same time or to have surgery on one eye at a time. Although the convenience of having surgery on both eyes on the same day is attractive, this practice is riskier than having two separate surgeries.

If you decide to have one eye done at a time, you and your doctor will decide how long to wait before having surgery on the other eye. If both eyes are treated at the same time or before one eye has a chance to fully heal, you and your doctor do not have the advantage of being able to see how the first eye responds to surgery before the second eye is treated.

Another disadvantage to having surgery on both eyes at the same time is that the vision in both eyes may be blurred after surgery until the initial healing process is over, rather than being able to rely on clear vision in at least one eye at all times.

Finding the Right Doctor
If you are considering refractive surgery, make sure you:

  • Compare.      The levels of risk and benefit vary slightly not only from procedure to      procedure, but from device to device depending on the manufacturer, and      from surgeon to surgeon depending on their level of experience with a      particular procedure.
  • Don’t base your decision simply on cost and don’t settle for the first eye center, doctor, or      procedure you investigate. Remember that the decisions you make about your      eyes and refractive surgery will affect you for the rest of your life.
  • Be wary of eye centers that advertise, “20/20      vision or your money back” or “package deals.” There are never      any guarantees in medicine.
  • Read.      It is important for you to read the patient handbook provided to your      doctor by the manufacturer of the device used to perform the refractive      procedure. Your doctor should provide you with this handbook and be      willing to discuss his/her outcomes (successes as well as complications)      compared to the results of studies outlined in the handbook.

Even the best screened patients under the care of most skilled surgeons can experience serious complications.

  • During surgery.      Malfunction of a device or other error, such as cutting a flap of cornea      through and through instead of making a hinge during LASIK surgery, may      lead to discontinuation of the procedure or irreversible damage to the      eye.
  • After surgery.      Some complications, such as migration of the flap, inflammation or      infection, may require another procedure and/or intensive treatment with      drops. Even with aggressive therapy, such complications may lead to      temporary loss of vision or even irreversible blindness.

Under the care of an experienced doctor, carefully screened candidates with reasonable expectations and a clear understanding of the risks and alternatives are likely to be happy with the results of their refractive procedure.