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Caster
Eye Center Excellence in Laser Vision Correction of Nearsightedness · Farsightedness · Astigmatism |
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Caster
Eye Center Excellence in Laser Vision Correction of Nearsightedness · Farsightedness · Astigmatism |
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Email:
April 19, 2006
Q: I went in for a consultation yesterday to see if I qualified for Lasik surgery. After a few tests were run the surgeon came into the room and told me that I didn't qualify for the surgery. He said that because my eyes are cone shaped instead of round they can't do the surgery. I asked if there were other options and he said that there weren't, and that I would have to wear contacts or glasses for the rest of my life. Can you explain what he meant when he said that my eyes were cone shaped? A: It sounds as if you may have keratoconus. This is a condition in which the tissue of the cornea is weaker than it should be. Thre is no surgery for this condition, unless it becomes severe, and laser vision correction in most cases is not performed. Andrew Caster, MD Email: April 19, 2006 Q:My question is - can LASIK harm the endothelium? I have 'endothelial changes' but not Fuch's Dystrophy at the moment. My corneas are healthy. One eye doctor that I have seen (Ultralase, Tottenham Court Road, London) is of the opinion that LASIK can cause the rate of degeneration of the cells in the endothelium to accelerate and will not perform the LASIK procedure on me for that reason. This is also the opinion of Adrian Chorley, the optician at Gatwick AMD. Another eye doctor in Cambridge has advised me that there is no real risk of this happening and said he would be happy to perform the LASIK procedure, leaving me pretty confused. He also diagnosed that my eyes had 'subtle discreet anterior lesions that were not characteristic of Fuch's Dystrophy'. So what do you think? If there is a risk, are you able to give me any idea how much of a risk it is? Many thanks - my career hangs in the balance. A: Patients with Fuchs dystrophy should probably not have the surgery, because the results tend to be slightly unpredictable. Also, people with Fuchs dystrophy who had Lasik can have some additional problems with the Fuchs in the future. But Lasik does not affect the health or degeneration of the endothelium. So other minor irregularities with the endothelium are probably not a risk. Andrew Caster, MD Email: April 20, 2006 Q: My Corneal Thickness is 468u. I was told that I would qualify for either CustomVue Lasik or CustomVue PRK. My choice. What do you recommend? Also which procedure would give me better results? A: It really depends on a lot of other factors. With the thinner corneas that you have, unless your prescription is low, I would lean towards PRK. Andrew Caster, MD Email: April 22, 2006 Q:
My brother had lasik 1 year ago, but complains that his eyes get tired and vision gets blurry after reading or watching t.v. for awhile. Is this normal? A:
Your brother should have a re-evaluation to see what his eye status is. Andrew Caster, MD Email: April 26, 2006 Q: Would I be better using the "bladeless" lasik technique if I am 62 years old and have a 9 degree of correction. My first interview with a surgeon said my cornea thickness was "average" and he had to do some calculations to see if they could do the procedure (presumably with the blade technique)? I don't have any eye problems other than myopia and small amount of astigmatism. I do, however, have high blood pressure (controlled) and take a blood thinner for Factor V. A: The bladeless technique is better for people with corneas that would be left too thin after Lasik with a flap. This depends on your precise measurements. Andrew Caster, MD Email: April 26, 2006 Q: Hello again Dr. Caster, I had asked you about lasik on people with a history of keyloid scarring back about a month ago. Since then I went in to 3 lasik centers in my area and 2 said that keyloid scarring has not been an issue. One center said they didn't have much experience with it but doesn't doubt that I should be fine. Their rational was that I have the benefit of knowing about my keyloid forming problem prior to lasik and with the number of people having this procedure chances are is that other people who do not know they have conditions like mine have had lasik and didn't have problems. Of course I am still concerned because after picking the center for the procedure they have sent me the consent forms. Specifically on there it asks me to disclose any of the following conditions to the surgeon. Specifically on there is - history of keyloid scarring with surgical healing.- My lasik is on May 3rd and I just want a little non financially interested intelligent persons insight on the whole deal. Also, the center I selected indicated that I have Blepheritis and want me to use zylet drops 3 times a day starting 1 week prior to surgery. What do you think? A: Keloid formation originally was felt to be a problem for lasik, but now, as the result of a lot of research, the general opinion is that it is not a problem. On your second question, many centers treat blepharitis prior to performing lasik. Andrew Caster, MD Email: April 26, 2006 Q: I'm 56 years old and my close up vision is fine; I can read the newspaper, work on the computer, see a small TV next to me on the computer desk perfectly with no glasses. I need glasses for driving, seeing signs far while driving, sitting in the movie theater, watching TV across the room etc. I wore 1 contact for years for distance, which gave me mono-vision and that worked for awhile. But now I feel 'off' or crosseyed if I try to read a label in the store, sign a receipt. My eyes don't vocus well with 1 contact. So I was wondering if Lasik would work for me and if so, would having both eyes done, would it impair my close up vision. Or if I had only one eye done Lasik, would that throw me off like wearing one contact. A: Having monovision with lasik is similar to having monovision with contacts. If you are 56 years old and have your distance vision corrected in both eyes, then you will need reading glasses. Andrew Caster, MD Email: April 29, 2006 Q: What does 20/60 binocular mean? A: At 20 feet, a person with 20/60 vision can see the size 60 letters, which are three times as tall as the letters in 20/20 vision, which is considered perfect. Andrew Caster, MD Email: May 01, 2006 Q: I had lasik about nine days ago, was seeing 20-25 2 days after the surgery, and I woke up this morning with my right eye seeing blurry. I was told to avoid pools and hot tubs for two weeks, but I was sitting BY a pool and hot tub yesterday for a couple of hours. Could this be the cause and if so, is there anything I can do? A: Although it is probably nothing serious, I would go and see your lasik doctor immediately, to make sure that it is not something serious that needs immediate treatment. Andrew Caster, MD Email: May 02, 2006 Q: I remember hearing about complications with Lasik and people who have climbed Everest. With Lasik, and after full recovery/healing, would traveling to high altitude regions be a problem? Snowboarding? Especially Skydiving? A: People who had the earlier form of refractive surgery, radial keratotomy (RK), have had problems on Mount Everest. I am not aware of any problems from Lasik in this regard. Snowboarding and skydiving are not a problem (at least as far as your eyes are concerned!). Andrew Caster, MD Email: May 03, 2006 Q: I have myopia and a lazy eye and have been recently using glasses. I am also fourteen. Is it recommended that I get Lasik eye surgery now or when I get older or maybe I just don't need it at all? A: You need to wait until your eyes stop changing, which is usually 18 or older. Andrew Caster, MD Email: May 04, 2006 Q: I had PRK on one eye because of my cornea thinness. The 6-month recovery was too long and painful so I am considering Intralase for my second eye. Was the long recovery due to the PRK surgery or the fact that I had a lot of correction done? Does more correction mean a longer recovery? A: PRK has a much slower healing process than Lasik. When you make a flap, regardless of how you make it, the healing process is significantly slower. In some cases, however, PRK (Lasik without a flap) is the safer approach. Andrew Caster, MD Email: May 07, 2006 Q: Dear Doctor, My name is Marditsa, I am 42 years old, I am coming from Greece. 2 months ago I had a Laser operation with LASIK method on my eyes to reduce or extinct myopia and astigmatism that I had and still have but less. The first week after the operation I couldn’t see clearly. After this period of time I started seeing properly but several black spots with several shapes appeared in both eyes that I didn’t see before, especially during the morning, when focusing on white surfaces but during night as well, hopefully less. When I move my eyes fast, the black spots follow the move of my eyes, they appear almost in the centre of my view where I focus and then if I continue focusing on there they start go lower until they stop moving in a lower place on my sight. Now after 2 months the situation is completely the same and the only thing that has changed is psychological situation. I collapse everyday more and more thinking that this situation may be permanent. I would be glad to hear your opinion. I am looking forward to receiving your email. Sincerely yours A: What you have are known as "floaters". These are very common in the population as a whole, but more so in nearsighted people, whether or not they have had laser vision correction. These are tiny peices of tissue that have come loose and are flaoting around inside your eye. Sometimes they float right into your field of view, which as you know is very disturbing. Typically they go away after a few months, but sometimes not for a few years. Although these can be treated with a laser, the treatment is too risky for the benefit, so there is no treatment that I would recommend. Andrew Caster, MD Email: May 10, 2006 Q: I am a scuba diver. Because of the pressure from diving into deep water, would it be safe on my eyes if I had Lasik, Wavefront or any other Lasik-procedure done? Also, how long should you wait after the surgery before diving? Thank you. -- Jimmy A: The pressure from scuba diving is not an issue after lasik. I recommend that people wait 1 week before they swim and 3-4 weeks before surfing or scuba diving. Andrew Caster, MD Email: May 10, 2006 Q: Hi! I'm planning on backpacking through europe early Sept. Would you recommend me getting Lasik before I go? A: If you can have your procedure at least 1 month before you go, then you would have plenty of time to heal, and you might enjoy your trip more than with glasses or contacts. Otherwise, have the treatment when you return. Andrew Caster, MD More Lasik Email Questions Pages |
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