Email: December 27, 2005 Q: Which of the eye surgeries does not require a removal of the flap? A: Lasik without a flap goes by many different names -- PRK, Lasek, Epi-Lasek. All of these are variations of the same procedure. Also, a lens can be implanted inside the eye in a procedure called phakic intraocular lens placement. Andrew Caster, MD www.castervision.com

Email: December 28, 2005 Q: Dear doctor, I am asking for an advice about the best eye treatment that is currently available. I am a hemophiliac however I want to get rid of my glasses as to have a more convenient life. I have a degree of -6.5 and astigmatism of around 3. Since I am a hemophiliac deficiencies in factor ( 8) I am confused to take what treatment that is the best and most suitable for my condition. What bothers me is that I am afraid that it may risk my eye-sight if I undergo LASIK treatment due to bleeding. I am entrusting on the expertise of the doctor to give me good advice upon which treatment that I should take if I want to have good eye-sight. Since there are many treatments that can be chosen such as LASIK, LASEK, CUSTOMVUE,CUSTOM LASIK and LASIK with intraLASE. A: I would recommend Lasek, with or without the Custom software, to lessen your chance of unwanted bleeding. Andrew Caster, MD www.castervision.com

Email: December 29, 2005 Q: I'm facing cataract surgery and have been asked to decide whether the affected eye should be made nearsighted or farsighted. Can lasik or PRK be performed after the IOL implant to correct the eye perfectly? If so, which option is best? A: Yes, Lasik can be performed after cataract surgery, if needed. Whether to have the eye adjusted for near or far is a personal matter that requires significant discussion with your doctor. Andrew Caster, MD www.castervision.com

Email: December 29, 2005 Q: My daughter had custom lasiks a couple months ago. She is suffering from dry eyes now and her vision is good some days and some days its not. The doctor that done it says it could take up to a year for the eyes to heal and stabilize. Is this correct? He told her to keep pouring eye drops in the eyes to keep them moist. I'm very concerned. She was legally blind without her contacts before she had this done. Her eyes get real bloodshot and I worry as a mother that her eyes have been ruined. Can you give me any input? Thanks, S. Jones A: There are several treatments that are available for dry eyes, including flaxssed oil pills, night ointments, and tear duct plugs. She should discuss these with her doctor or see another doctor. Andrew Caster, MD www.castervision.com

Email: December 30, 2005 Q: I had a failed attempt at monovision and a re-surgery to eliminate it. After being told what a great result I had, I found out I was really nearsighted in one eye and far sighted in the other with lasik induced astigmatisms in both eyes. After months of dizziness, nausea and headaches and disability, I went to an OEP optometrist who says my corneas are as wavy as funhouse mirrors. RGP's may be my only hope of functioning normally.Why did this happen and what would you call it? A: I would recommend getting another opinion, just to be sure about the outcome. Further surgery may be possible. Andrew Caster, MD www.catervision.com

Email: January 02, 2006 Q: I am reading more ads advertising Advanced Surface LASIK with the Allegretto Wave and NO incision or corneal flap. Isn't this just a fancy name for PRK, where they ablate the surface of the cornea, destroying the epithelial layer, which I have read in the past does NOT heal or grow back? What difference (if any) is there between PRK and No incision Advanced Surface LASIK with the Allegretto Wave? A: No, incision Advanced Surface Lasik is the same as PRK. It can be performed with the Allegretto or any other laser, such as Visx, Bausch and Lomb, or Alcon. Andrew Caster, MD www.castervisin.com

Email: January 03, 2006 Q: What does no worse than 20/60 binocular mean? Thank you. A: With both eyes together, a person with 20/60 vision can see the size 60 letters at 20 feet. The size 60 letters are three times taller than the size 20 letters that a person with 20/20 can see. Andrew Caster, MD www.castervision.com

Email: January 03, 2006 Q: Hello Doctor, I used to live in San Diego a big city but now I am in Ohio. My question is how can I find an experienced doctor to do my Laser surgery and since this is a small town with few jobs, would I be better off going to a big town to search for a doctor? The reason being more experience. I live in Youngstown, Ohio. Thank you, Richard...... A: Since you will be using your eyes for the rest of your life, you will want to find a very good Lasik doctor, wherever you have to go. Andrew Caster, MD www.castervision.com

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