Email: January 18, 2005 Q: I am writing a feature article on laser eye surgery and its effects. I would like to know your opinions on the people who have the surgery, and have suffered as a result of it. Are complications in the sugery common? what problems can occur during and after the surgery. Thank you for your help. A: Serious complications are very rare, and are usually treatable. There are a lot of websites that discuss complications. Andrew Caster, MD

Email: January 18, 2005 Q: I am one week post-lasik, I had a steep correction of 8 diopters. One eye is seeing 20/40, and the other is 20/70. But there seems to be no clarity or focus in anything I look at, my dr. does not seem concerned and wants to do a second surgery in 3 months and has temperarily fitted me with contacts. Even with the contact nothing is sharp as it used to be before lasik. What is going on, and will the bluryness be permanent? A: You may need a touch up to get rid of the blurriness. You should have been carefully explained this by your doctor. Andrew Caster, MD

Email: January 19, 2005 Q: I had laser surgery in 2003 and the doctor said I had -3.00 or more I don't remember, on both eyes. (i had astigmatism and myopia) After the surgery I was 20/20. He said I had recovered more than 100of my vision. After 4 months I notice that my eyes were extremely tired and I was not seeing well at night. I went back and he said that I needed surgery again (re-touch). So I had surgery again this was back in 11/2003 and again I cannot see things that I was able to see after the first surgery. At school sometimes I cannot see the board and my eyes get very tired and they hurt. I went with another dr. and he said that now I have -1.00 -0.75x40 on the right eye and 1.00 on the left. But I don't want to wear glasses any more. What happened to my vision. A: It appears that your eyes are still changing. Lasik will not stop your eyes from changing, so it is advisable to wait until you reach an age that your eyes stop changing. I would not recommend another enhancement now. I would wait until there is no change for two years. Andrew Caster, MD

Email: January 20, 2005 Q: I heard of a procedure that actually doesn't cut at all. You actually sew or glue a lens right to the eye itself. Then if technology changes you can have it removed and improved. What is the name of this procedure and how does it compare to Lasik? Thank you! A: It is called phakic IOL or phakic implant. It is a foreign body in the eye, so it is more invasive and possibly has more complications that Lasik. Also, you can remove the lens if you want to, but that will not undo any damage that the lens might have done. Andrew Caster, MD

Email: January 20, 2005 Q: I went for my inital screening and was told that I had up to a 7.2mm pupil in total darkness, and that the docot would perform a the surgery with a 7mm laser. This area of .2 would cause me to undoubtably have halos and starbursts, correct? A: Not necessarily. Most people in this situation will have only minimal halos. Remember, you have some halos now with glasses or contacts.

Email: January 20, 2005 Q: I had lasik back in 2001 and now notice vision worsening again. Is this normal or should I be concerned about something more serious? Is this correctable with a touch up procedure? A: It would be best to get an eye exam to determine what is going on. Andrew Caster, MD

Email: January 20, 2005 Q: I wanted an eye doctor's opinion--since I have moderate dry eye can CK be performed on my eyes? I am 57 years old. When I wore contacts my eyes were =1.25 (right eye) 1.50 (left eye) Add 2.25 (for glasses prescription) A: CK can be performed on people with moderate dry eye. Andrew Caster, MD

Email: January 21, 2005 Q: I am about to have my 3d Lasik procedure. The first 2 were in 1998. My starting nearsightedness was approx 4.0 in each eye. Is there any add'l or undue risk in going back for a 3d time? Mycurrent vision is about 80-20 and I want 20-20!! I play golf a lot and I love the outdoors. I am willing to wear reading glasses. I am a lawyer. Thanks. A: Each time there is a risk of infection, flap problems, etc. No additional risk becasue it is the third time. Andrew Caster, MD

Email: January 22, 2005 Q: I am seriously considering having Lasik done but I recently heard not-so-encouraging stories about my relatives having to go back to wearing glasses. Their vision is not 20/20 anymore. One of them is my 28-year-old cousin. She had it done five years ago. It was great at the beginning but now she has to wear glasses when she drives and reads. It has only been five years. The other person is my sixty-two-year-old aunt. She is having problems seeing too. She had it done roughly the same time my cousin did, five years ago. She now wears glasses all the time. She said her eye sight changed. What went wrong? Or this is to be expected? A: No one should have Lasik unless their vision is stable. This is why you should be careful who you go to for the surgery. Andrew Caster, MD

Email: January 23, 2005 Q: For custom Lasik, Do the patient get 20/20 vision right after surgery and then vision may change during healing? During Healing, do the patient normally get better vision or getting worser vision. Thanks. A: Usually, the vision gets better as it heals. Andrew Caster, MD

Email: January 24, 2005 Q: Even though CustomVue is currently only FDA approved for use with LASIK, is the use of CustomVue similarly safe and effective when used in conjunction with PKR surgery? A: It is believed to be safe and effective with PRK, and is commonly used in this context. Andrew Caster, MD

Email: January 24, 2005 Q: I am considering getting Lasik in Bumrungrad Hospital in Bangkok, do you have any information on this hospital or its eye surgeons. Also I am from Ireland and the clinic that performs the surgery there insists that patients do not wear contacts for one month before the operation, is this necessary. Thanks A: You should stay out of the contacts for a period of time before the lasik. Andrew Caster, MD

Email: January 25, 2005 Q: please sent me more information. A: I will ask Diane from my office to call you. Andrew Caster, MD

Email: January 26, 2005 Q: Hi Dr., I have had my Lasik with Intralase done for nearly 2 months. Currently using the eye drops FML® (Allergan) recommended by the surgeon. Is it usual to use this and how long should be used. Any side effects for prolonged use. Further, I found there some conjunctivitis, sort of broken veins in the white part of the both eyes after the surgery, how can I get rid of it. Thx. Jose. A: These drops can casue glaucoma in rare cases, so you must be followed closely by your doctor and follow his instructions. Andrew Caster, MD

Email: January 26, 2005 Q: Hi - I was wondering if I would be able to wear contacts after LASIK if they were not able to correct my eyesight competely and also - does the flap always stay on your eye or does it heal? Thank you so much for your answers - I really appreciate it! Heather A: You can usually wear contact lenses in the rare situation where you might need them. Andrew Caster, MD

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