Email: October 12, 2004

Q: Dear Sir,
I am a 15 year old Australian high school student,currently working on a medical technology assignment.
The question i need answered :
What impact and affect will Lasik surgery have in the future?
Looking forward to your reply.
Thank You
Matthew Kafer.

A: I think that Lasik will continue to be the most commonly performed surgery each year in the United States, as well as in other countries. It should only continue to have a greater and greater impact each year.
Andrew Caster, MD
Caster Eye Center
Beverly HIlls, California

Email: October 14, 2004

Q: I want to find out what type of operations are available now with todays technology for a 7year old boy with congenital glaucoma and about loosing vision on the right eye

A: There are many excellent operations available. You need to see a glaucoma specialist.
Andrew Caster, MD

Email: October 13, 2004

Q: Hi, my daughter has been wearing glasses for 7 months now,and she doesn't like them at all. So I was considering the lasik surgery for her, but I need to know if there's a starting age for the surgery?

A:Usually 18 is the youngest age.
Andrew Caster, MD
Beverly HIlls, CA

Email: October 13, 2004

Q: Sir,
How long does it take the eye to return to its normal shape once contacts are removed? I am getting the Lasek surgery in 2 weeks and they told me I needed my contacts out for 2 weeks prior. I only had them out for about 3 days prior and did not disclose that information because I would have lost my slot to get the surgery. Your response would be much appreciated. Thanks a lot Sir.
Very Respectfully
Marc Vielledent

A:For soft lenses, 10-14 days.
For gas permeable, 6-8 weeks minimum.
Andrew Caster, MD
Beverly Hills, CA

Email: October 13, 2004

Q: I have a astigmatism problem with one or both eyes, would I be able to successfully receive lasik sugery?

A: Lasik can correct astigmatism.
Andrew Caster, MD
Beverly Hills, CA

Email: October 13, 2004

Q: I have been told my corneas are too thin to do lasik and the Verisyse procedure may be right for me. Is the Verisyse the only procedure I may be able to have or would the custom lasik with the wavefront(?) guidance be an option for me?

A: Custom lasik requires even more cornea, so it probably would not be an option.
Andrew Caster, MD
Beverly Hills, CA

Email: October 14, 2004

Q: I am 44 years old with myopia 700 - 800 degree and astimatism 100 - 200 for both eyes. I have had my eyes assessed and doctor said I am a good condidate for LASIK sugery. He is not going to use wavefront-guided LASIK on me because wavefront-guided LASIK is more suitbale for younger age around 20 plus and he also said the latest technology had yet to be proven it was the best. I am confused and do not understand why many patients were then performed surgery using wavefront-guided LASIK. May I have your opinion? I also heard that doctors would normally give patients double vision after sugery, i.e. to under-correct one eye and over-correct the other eye so that patients can see cleary both from far and near. Is it true? I would appriecate very much if you could advise. Thank you.

A: Each doctor has his or her own guidelines about whether to use wavefront or not. Also, many people your age will choose to have one eye for near, one for far, but many others want both for far.
Andrew Caster, MD
www.castervision.com

Email: October 14, 2004

Q: HELLO. I'VE BEEN TO 2 LASIK CONSULTATIONS. ONE PLACE RECOMMENDED THAT I WAS ELGIBLE FOR PRK AND NOT LASIK BECAUSE MY CORNEA IS TOO THIN. THE OTHER PLACE ALSO SAID MY CORNEA IS THIN BUT I WOULD BE ELGIBLE FOR LASIK FOR $4500 WITH LIFETIME TOUCHUPS. THEY SAY THE PRK IS MORE PAINFUL W/LONGER RECOVERY, RIGHT? THAT IS WHY I'D RATHER GO WITH LASIK. BUT IS THE $4500 A LITTLE TOO STEEP IN PRICE EVEN W/THE LIFETIME TOUCH UPS. WHAT DO YOU RECOMMEND I DO? SHOULD I KEEP SEARCHING FOR DIFFERENT PLACES? BECAUSE WHAT I REALLY WANT IS THE LASIK WITH A PRICE THAT'S RIGHT AND POSSIBLY LIFETIME TOUCHUPS (SINCE I AM ONLY 24YEARS OLD AND I KNOW MY EYESIGHT WILL STILL CHANGE). I WOULD APPRECIATE YOUR HELP. THANKS.
CHERYL

A: First of all, price should be the least of all your considerations when choosing a Lasik doctor. This is your vision, and you will use it every waking moment.
I would recommend finding out about the reputations of the Lasik doctors, and get one or more opinions.
Andrew Caster, MD
Beverly Hills, CA

Email: October 14, 2004

Q: I had wave front lasik surgery about 1 year ago. my vision has greatly improved from -10 to a -1.75. I was suppose to have a second procedure performed to further correct, but my surgeon warned me about possibility of unstabilizing the eye. He explained to me about the region behind the cornea has slight deformation and he is not certain if it was the result of the surgery.
If he goes ahead with another procedure he is afraid it can unstabilise this region.
I consulted a second surgeon who told me he did not see a problem with the repeat procedure.
He mentioned there was plenty of cornea thichkness & curvature to play with.
I am confronted to make a decision by october 18th.
My surgeon cannot quantify the risk factor of creating this unstability, which he explains can happen not right away but later on.
Has anyone had experience with this & do you have any advice??

A: First of all, there is no medical deadline that happens on zOct 18. This is a medical decision, and that must outweigh all other factors. Do not do anything until the issues are clearly delineated. Consider obtaining a third opinion.
Andrew Caster, MD

Email: October 14, 2004

Q: How do i know im getting what i'm paying for ? What if complacations arise? Is that usually xtra?

A: Typically, the fee involves the cost of dealing with complications afterwards, though many cutrate places will bill you extra. I would avoid those places.
Andrew Caster, MD

Email: October 14, 2004

Q:I am considering Lasik surgery. The doctor has given a mild to moderate recommendation for custom lasik as I have "thinnish" corneas.What information should I be looking for to help me make this decision? Given the procedure is twice as expensive as the regular lasik I obviously want to know if it's worth the extra cost. Thank you so much!

A: There are a lot of factors, which I cannot go into here. Custom makes a subtle difference. If the money is critical, then most people can be satisfied without the wavefront custom treatment.
Andrew Caster, MD

Email: October 15, 2004

Q: I have had laser surgery 9 days ago. i am 50 years old and fit and healthy. i was shortsighted. since the surgery, i have had burst blood vessels in both eyes, still present now, do i keep using the drops and saline solution. my vision is not as good as i expected. my eye muscles are taking time to settle. i have seen my doctor once.i need reading glasses to see now and my distance vision is not sharp. i am not in pain. thanks jenny

A: The broken blood vessels will usually heal in 2 weeks or so. Everything else you describe is perfectly normal.
Andrew Caster, MD

Email: October 17, 2004

Q: I assume this is probably for people looking to get the surgery done but it's worth a try. I had PRK done (here in Canada) last Friday, 10 days ago. So far I am extremely disappointed with the results. My Rx prior was about 3.5 diopters, moderate at worst. Now, I am unable to see clearly at any distance. Faces, numbers and street signs are nearly unrecognizable. My doctor here tells me not to be worried but (admittedly) its been awhile since he's done a PRK and doesn't remember well how long it takes to heal. Do I just keep waiting? Thanks in advance,
Andrew

A: PRK can take several months to obtain optimal vision.
Andrew Caster, MD

Email: October 17, 2004

Q: I am farsighted with astigmatism. I am 51 yrs.old. What is the best lasik for me? I had a consultation. They said I could correct for distance and then I would just need reading glasses. Or I could fix close up but then it would be blurry for far away. ( That did not sound good to me.) Or I could fix one eye for far and one for close up. What do you think about the last one? Does that work well and is it bothersome? I actually made the appointment for the 1st solution but I am thinking about doing the last solution of one eye far one eye near. What do you think?

A: The best solution is what works best for you personally. Your doctor should show you with glasses each of the options and then you can make an informed choice.
Andrew Caster, MD

Email: October 18, 2004

Q: I had Lasik 1 year ago so can I have custom Lasik now??

A: Yes, if you need it. Most probably you will not need it.
Andrew Caster, MD

Email: October 20, 2004

Q: I had LASIK; ladarvision; about two weeks ago. My left eye is fine. Great vision. My right eye is terrible. Very blurry vision. I have been back three times, and I am scheduled to go back in a week. The doctor says that the right eye is very dry and swollen and that is why the vision is bad. She says the flap is fine. Is this true? Should I get a second opinion? How long will it take before I know if this is going to clear up or not? Currently her advise is to continue to use non-perservative artificial tears and Muro 128 5 three times a day. Is there anything else I should be doing? Thanks.

A: It might ease your mind to get a second opinion, but dryness and swelling certainly do occur.
Andrew Caster, MD

Email: October 21, 2004

Q: Hi. I've had a consultation for laser eye surgery and have been told that I have larger than normal pupils in dimmed light. I think around 8-8.2mm. Does this mean that I will more than likely have glare/halos or is there a chance that I may not? They said that it would probably no worse that what I already experience with contact lenses and glasses - is this true? If so surely I'm no worse off. Also could I wear glasses when driving to correct the glare/halos. Thank you in advance for you help.

A: Some patients have glare and halos after Lasik. Usually it is correctable with an enhancement, but not in all cases. It is not clear what the role of larger pupils is in resulting halos, but they may play some role. I tell patients that larger pupils are a risk factor for halos, though this is not defintitely proven.
Andrew Caster, MD

Email: October 21, 2004

Q:had lasik done 2 weeks ago..i am undercorrected according to my doctor....he said enhanchment can be done in several months.
my worry is that i had -6.50 and -5.00 in both eyes before lasik..now my eyes are about 20/70 and dr prescribe temporary glasses for me for driving until enhanchment can be done..i got my glasses back today and i still cannot see clearly..just little better in left eye....when he was tryng to my reading on me to get glasses i was having problems seeing anything clear..he said at that time my eyes are still healing and that is why cannot get a good reading for glasses..my close vision is now excellent with reading glasses. i am worried that i have lost the ability to get my corrected vision back forever after laser surgery..any thoughts would be appreciated.
thanks
johna

A: I would not be worried at this time, as it can take several weeks or sometimes months to stabilize. If you continue to be concerned then get a second opinion.
Andrew Caster, MD

Email: October 21, 2004

Q: I HAD LASIK SURGERY AND I WOULD SAY MY VISION IS WORSE AND MY UPPER EYELIDS DROUP TO THE POINT THAT IT MORE THAN JUST ANNOYING. ITS BECOMEING DIFFICULT TO SEE .I CAN'T REALLY EXPLAIN, HAVE YOU HEARD OF THIS HAPPENING?
SUSIE

A: In very rare situations, the eyelids can droop a little bit after Lasik, but not to the degree that you describe. I would get an evaluation by a doctor, but would think about another casue.
Andrew Caster, MD