N. Timothy Peters, MD
Christopher Turner, OD
Lauren McLoughlin, OD
Clear Advantage Vision Correction Center
155 Borthwick Avenue
Suite 200 East
Portsmouth, New Hampshire 03801
The mission of Clear Advantage is to provide our patients with the most technologically advanced vision correction options in New England. Our highly experienced surgical staff is dedicated to educating patients on a variety of refractive procedures in a personalized and comfortable manner.
Centrally located in Portsmouth, NH, and just one hour from Boston, MA, Manchester, NH and Portland, ME, Clear Advantage is easily accessible. Located just two buildings away from Portsmouth Regional Hospital, our location at 155 Borthwick Avenue is in the heart of the seacoast medical community and home to some of the top medical professionals in the world.
Understanding Your Vision
Clear vision is achieved when light rays are focused and processed by the many parts of the eye. Light travels from an object and enters the eyes through the cornea, which is the transparent outer covering at the front of the eye. The cornea helps focus, or “refract” the light, which then passes into the interior of the eye through the pupil. The iris, or color portion of your eye, opens and closes — like a camera shutter — making the pupil larger at night to allow more light in, and smaller in sunlight to decrease brightness. Next, the light passes through the lens of the eye, which changes shape to focus the light onto the retina at the back of the eye.
When looking at nearby objects, more focusing strength is required in order for the image to remain clear. The lens increases focusing strength by becoming more convex in shape, a process called accommodation. All of the eye’s parts must be correctly tuned for images to be clearly focused on the retina. The eye’s shape is also important in determining clear vision. If the eye is either too long (myopic), or too short (hyperopic), light rays are not focused properly on the retina. If the eye is unevenly shaped (astigmatism), images will also be blurry.
- Nearsighted (myopia) – images are blurred at a distance and are clearer at close ranges. Eye is longer and the cornea is steep.
- Farsighted (hyperopia) – images tend to be blurred at all ranges, but distance vision is the clearest. Eye is shorter and the cornea is flat.
- Astigmatism (can be combined with myopia or hyperopia) – blurred images at all ranges. Eye is shaped more like a football than a basketball.
- Presbyopia (reading glasses) – generally occurs over the age of 40 as the lens of the eye gets thicker and cannot bend to focus on near tasks.
Once the surgeon has determined that you a candidate for laser vision correction, you can often schedule your procedure within the same week! Surgical appointments run every half hour from 10:00 a.m. to 6:00 p.m. on Thursdays, and 9:00 a.m. to 4:00 p.m. one Friday per month.
If you schedule surgery:
- We will either write or call in prescriptions for two medicated eye drops that you will use four times a day for one week after surgery. We can also call in Valium for the day of surgery.
- You will be at our office for approximately one hour. Your actual procedure is only about 15 minutes.
- You will need someone to give you a ride home from our office after surgery. Our staff will be happy to assist you with arranging a date and time that best accommodates your needs.
- We will schedule a follow-up appointment to see you the day after the procedure.
- There is almost no recovery time with LASIK. You should be able to drive yourself to the 1-day appointment. Most of our patients return to work and normal activities the same day!
- After your 1-day appointment, you will be seen at the 1-week, 1-month, 3-month and 1-year marks. We have established close relationships with nearly 500 optometrists in the New England area. Chances are your doctor is in our co-management group, so your follow-up appointments can be made at Clear Advantage or with your regular eye doctor at no extra charge!
The LASIK Procedure – Step One
The LASIK Process – Two Easy Steps… One Phenomenal Outcome!
Step One – Exposing the Cornea
The first step in vision correction is to create a thin flap in the cornea. In order to correct vision, it is necessary to expose the corneal layer beneath the surface, called the stroma. This is where the excimer laser will do its work in reshaping the cornea with a LASIK, Advanced LASIK or Customized LASIK treatment.
Femtosecond Bladefree Laser: Use of the DaVinci femtosecond laser during vision correction increases safety and precision. A femtosecond is a quadrillionth of a second, and this is the speed of each DaVinci laser pulse. Rather than having a traditionally used blade cut the corneal flap, the DaVinci uses a fast, pulsed laser to create many microscopic bubbles just below the corneal surface. The laser moves back and forth over the designated treatment area on the eye, and creates a round, shallow area of these tiny bubbles. Then the surgeon uses a special instrument to gently lift that tissue and fold it back out of the way.
PRK: If the cornea is too thin for LASIK or if you have undergone LASIK previously and have a thinner residual cornea, then PRK may be an option presented during your evaluation. During PRK, the cornea’s epithelial (outer) layer is removed using a special solution to expose the area, and no flap is created. For both PRK and LASIK, the excimer laser then sculpts the stromal layer of the cornea to correct your refractive error. Though PRK recovery takes a bit longer than recovery from methods utilizing flap creation, PRK is still commonly used worldwide.
Step Two – Reshaping the Cornea
During the evaluation, our doctor will calculate the treatment option that will offer you the best visual results. This is determined by your prescription, the thickness of your cornea, your astigmatism, and the amount of aberrations recorded during your evaluation. We are proud to offer several different treatment options:
Traditional LASIK (Laser Assisted In-Situ Keratomileusis)
LASIK combines the proven techniques of both corneal flap and excimer laser surgery, resulting in dramatic results and rapid visual recovery. LASIK is effective for correcting most cases of nearsightedness, farsightedness and astigmatism.
Advanced LASIK with the Mel80 System by Zeiss
Clear Advantage is the first and only practice in New England offering advanced LASIK treatments using the ultra-precise Zeiss Mel80 system. As of August 2006, this was the latest laser to be approved by the Food and Drug Administration (FDA). The MEL80™ is a fifth generation laser and one of the fastest lasers in the world.
The speed of the Mel80 shortens the treatment time, and thus shortens exposure time which helps enable a faster visual recovery. The MEL80™ also has a new, ultrafast eye tracker. As a result, this tool for all-laser LASIK is greatly beneficial for our patients, and we are proud to offer such cutting-edge technology.
Zyoptix Customized LASIK by Bausch & Lomb
The Zyoptix system utilizes Advanced Control Eyetracking (ACE) which allows the laser to compensate for eye movements during the procedure, thus adding an important level of assurance. Until mid-2009, no eye tracker had been able to adjust for subtle rotations of the eye that occur during the laser treatment. Using the latest technology, the laser corrects refractive errors by utilizing its small beam profile to flatten the cornea centrally and then “polishes” the periphery, or transition zone, to produce an extremely smooth cornea. It is capable of performing wavefront-guided and traditional LASIK procedures. It is also ideal for patients with large optical zones and/or mixed treatment requirements.
Our practice offers only the most advanced FDA-approved procedures. We offer multiple laser platforms to ensure the safest and most accurate procedure possible regardless of your astigmatism or nearsighted or farsighted prescription.
The Evaluation Process
The first step to learning about vision correction options and what option may be best for you, is to schedule a comprehensive evaluation with our office.
- Evaluations are offered Monday, Tuesday, Wednesday and most Fridays beginning as early as 7:30 a.m. and as late as 5:00 p.m.
- The evaluation should take no longer than an hour and a half, depending on your questions and any additional testing that may be required.
- The evaluation is complimentary. Your evaluation can be scheduled by contacting our office at 603-501-5000, or you can schedule your evaluation directly through our website at www.ClearAdvantageLaser.com.
Because contact lenses alter the shape of the cornea, preventing an accurate measurement, it is important that you do not wear soft contact lenses for five days prior to surgery; toric lenses, or astigmatism correcting lenses, should not be worn for 10 days before surgery; and hard contact lenses should not be worn for eight weeks prior to the evaluation AND prior to surgery. For example, if you have an evaluation but do not plan to have surgery for a few months, it is safe to put your contact lenses back in after the evaluation, as long as they are removed again before surgery for the same amount of time. If you wear toric or hard lenses, we also offer mini-LASIK evaluations. Although a full evaluation will still be required, a 20 minute mini-evaluation will allow us to take preliminary measurements to better determine the likeliness of your candidacy for vision correction. Call our office for details.
During the Evaluation
- During evaluation we take a number of highly technical topographic images of your eyes. These photos enable us to measure the thickness and curvature of your eye. Your eyes will be examined both before and after dilation. It will be completely safe to drive after the evaluation, but your eyes will be sensitive to bright light, so we recommend that you bring sunglasses with you (some will be provided if you don’t have any). Small text, such as a phone book or computer screen, may also appear blurry for the first four to five hours after you have completed your evaluation.
- At the end of the evaluation, our ophthalmologist and/or optometrist will discuss the results of the evaluation with you and recommend the type of procedure that will offer you the best visual results.
Unlike other LASIK practices, we don’t have a “sliding scale” of costs, adding costs to your procedure for follow-ups, dry-eye treatments or enhancements. In fact, we offer many discounts to make your lifelong vision change more affordable. Pricing is based on your procedure, and that is based on the prescription, pupil size, corneal thickness and aberrations. Until we see you for your evaluation, we don’t know which procedure would offer you the best visual results, but are happy to explain the general characteristics of each.
Insurance does not generally “cover” the cost of corrective vision services, but we are in contract with most of the major vision and medical plans to offer discounts. We currently offer discounts through:
- Block Vision
- Blue Cross
- Family Members
- Federal Blue Cross
- Harvard Pilgrim
- Matthew Thornton
- MetLife Vision Access
- NYS – NY State
- Optum Health & Health Allies
- Preferred Vision Care
- Premier Lasik Network
- Surency Vision
- United Healthcare
Interest-Free Financing for up to Two Years:
Interest-free plans are available for 6, 12, 18 and 24 months; extended plans are available up to 60 months (with interest). For more information go to www.CareCredit.com. Applying is easy, and can be done online for instant approval!
Save 15 percent if two or more family members have corrective vision services within one year. Save an additional 5 percent if two or more have surgery the same day.
Medical & Military Discounts:
We offer discounts for individuals working in the medical field, and for those actively serving in the armed forces.
Corporate Vision Program:
Does your organization employ 10+ people? Ask your benefit department to sign up for our FREE Corporate Vision Program. The Corporate Vision Program includes a significant discount on LASIK vision correction not available to the general public, and participation costs your company NOTHING! Best of all, the program is available to all employees — regardless of their insurance benefits or whether they are full-time, part-time or volunteer. Contact our office for more details or to sign up.
Lifetime LASIK Guarantee:
Our surgeon, N. Timothy Peters, M.D., has performed over 21,000 successful LASIK procedures. Of these procedures, less than 2 percent required an enhancement. An enhancement is a LASIK re-treatment that is available if the initial LASIK procedure does not correct all of the prescription. Patients with significantly high prescriptions make up the majority of those needing an enhancement to obtain full correction. While most competitors charge an upfront fee for an enhancement “guarantee,” Clear Advantage offers LASIK patients re-treatment at no additional cost. This represents a typical savings of $1,000 per eye. In addition, patients who maintain annual routine eye care with their eye care professional following LASIK qualify for our Lifetime Guarantee. This guarantee provides re-treatment at significantly lower rates than those charged by competing practices. A copy of the guideline will be supplied during your evaluation.
The Visian ICL (Implantable Collamer Lens)
The latest in eye surgery is the Visian Implantable Contact Lens or ICL, which was originally designed for patients who were not candidates for LASIK surgery due to high myopic (nearsighted) prescriptions. But the success of the Visian ICL implant has resulted in an increased interest from candidates who are also considered good choices for LASIK.
The Visian ICL is an Implantable Collamer Lens that works with the eye to correct patients with moderate to severe nearsightedness. Unlike traditional contact lenses that go on the surface of the eye, the Visian ICL is positioned inside the eye between the iris and the natural lens where it stays indefinitely. With a satisfaction rate of over 99 percent many of our patients choose the Visian ICL to get the freedom from their contact lenses and glasses that they’ve always desired. The Visian ICL is the procedure of choice for patients who need and expect higher quality results in performance and safety. In fact, the U.S. Military has embraced the Visian ICL because of the reliable visual clarity it achieves. Much like the recovery with laser vision procedures like LASIK, results are very fast with the Visian ICL.
Limitations of LASIK – Advantages of an ICL
- Ranges of nearsightedness – Most surgeons agree that LASIK should not be performed on ICL can be used for anyone between the ages of 18 and 45 with -4.00 to -20.00 diopters of nearsightedness.
- Glare and halos – Changing the natural curve of the cornea with LASIK may induce aberrations that can lead to glare and halos in some patients. Glare and halos are less common with ICLs because they cause less aberration in the eye.
- Medical considerations – Patients with lupus, Crohn’s disease, rheumatoid disease and dry eye syndrome are at a higher risk for complications with LASIK procedures, but are at less risk of worsening conditions after an ICL.
There have been over a million Visian ICL procedures performed worldwide.
Schedule your evaluation online or find out more about us at: www.ClearAdvantageLaser.com.