Email: June 28, 2006 Q: I got my LASIK eye surgery done 5 weeks before. My left eye is perfect (20/20), but I am not even able to read the first E in the eye chart with my right eye. I was told that my right eye should heal and it may take up to a max of 6 months. Can you please advise me on this. Thanks. Narmada A: I would obtain a second opinion to determine exactly what is going on. Andrew Caster, MD

Email: July 04, 2006 Q: After getting PRK are your chances higher for needing reading glasses? I thought I read that somewhere.........that later on in life when you are older your chances of needing glasses for seeing up close increase. Is this true? Is it a definite or just a small possibility? (I know it's natural at a certain age to need reading glasses anyway). Thanks. A: Any person who has good distance vision in both eyes -- either because they wear contact lenses, have laser vision correction, or wear glasses for distance -- will have trouble with near vision starting on average around age 45. Laser vision correction does not change this at all. If you wear glasses, then you can get bifocals. If you wear contacts or have laser vision correction, then you can use reading glasses when needed. However, people who are nearsighted and who use glasses or contacts can remove the glasses or contacts and they will have close up vision, depending on their prescription and age. Andrew Caster, MD

Email: July 05, 2006 Q: Hi, can I wear contact lenses for cosmetic reasons after doing the LASIK surgery? A: Yes, you can wear cosmetic contacts after Lasik. Andrew Caster, MD

Email: July 05, 2006 Q: I'm 34 years old and have been told by my opthalmologist that I'm a good candidate for Lasik. My extensive eye exam will be done in August. I'm quite nearsighted. I don't know my exact prescription but it's around - 6.5 and a little more in the other eye. I'm very scared about having complications postop and losing my eye sight completely. That is my worst nightmare coming true. Any comforting thoughts or your honest opinion about my fears. Am I right to be so apprehensive. Your opinion will be greatly appreciated. A: I have never heard of a patient losing their eyesight completely from laser vision correction. I assume that it is possible, but I am not aware of even a single instance of this happening. Andrew Caster, MD

Email: July 05, 2006 Q: I have been told that I have thin corneas (510)so I am not a candidate for LASIK. I also have steep corneas (-6) I am however a candidate for PRK. One doc said I should not have the custom vue procedure done because of the thin corneas. One doc said I can have the custom vue done. Both use the LADARVISION. Who do I trust? A: It is often difficult when you receive differing opinions from two different doctors. This happens because there are no clear-cut answers to certain questions, so different doctors can have different opinions about what is best. Which doctor do you innately trust more to make the most informed decision? Look to education, reputation, and a sense of caring. Andrew Caster, MD

Email: July 05, 2006 Q: I am 22 and have very poor vision (about -8.00 in each eye). Is my vision too bad to get surgery ? How bad can my vision be and still be able to get the sugery done? A: Usually, laser vision correction is available for -8.00. Andrew Caster, MD

Email: July 15, 2006 Q: My Dr. says my cornea is too thin for lasik, he says you need 250? and I have 272. He's on the conservative side and feels prk would be a better choice. What do you think? I like the idea of a quicker recovery time. A: I would recommend PRK in your case. Andrew Caster, MD

Email: July 29, 2006 Q: Greetings, On 27 July, I had intralase / lasik surgery. While the right eye went well, the intralase procedure on the left eye failed to completely seperate the flap. Specifically, the flap was still attached in the vicinity of the pupil. The surgeon was unable to successfully lift the flap and complete the procedure without risk of tearing. I am now in recovery and have been told that I should pursue PRK in a few months. Question 1: My surgeon has extensive experience with laser eye surgery (over 18,000 operations) and states that this is the first time he has seen this occur with intralase. Do you have any statistics relating the occurence of this anomonly with intralase and any insight as to the root cause of the failure. 2. Do you agree with the recommendation that I proceed with PRK once the eye has healed or is there a better approach? A: This is very rare. I am not surprised that this is the first time that it has happened. I have not had this problem yet, but eventually it will happen. I agree that you should have PRK. You should have an excellent result and be very happy. Andrew Caster, MD

Email: July 29, 2006 Q: I scar badly (keloid). Would this limit my options in Lasik surgery? Is there any research on the surgery on people who don't scar well? Thanks for your help. A: People who scar badly, forming keloids, do not have a problem with Lasik. The cornea reacts differently than the skin. Andrew Caster, MD

Email: July 31, 2006 Q: What are the reasons that a patient or a doctor would use the Allegretto Wave over the VISX w/customvue? The Allegretto reports that 87 of patients see 20/20 one year after surgery and VISX S4 Customvue reports that 98 of patients see 20/20 one year after surgery. There must be a reason since many top docs have chosen Allegretto. The "top" doctor in my area (highest volume, best marketing) uses Allegretto but there are a few great doctors in the area with tons of experience that use the VISX w/customvue. Also, my pupils dilate to 7.5mm and 7.6mm in low light. Allegretto is 4.5mm-8.0mm optical and VISX is 6 with a transition to 9mm. Is the ablation zone large enough to reduce the chances of night halos for me? Does that mean one is better for Halos? Allegretto doesn’t use wavefront and customvue does? Is it not important? Why would a top doc get a laser that doesn’t have wavefront? Does the optical zone have to be larger than my pupil size or does the "transition zone" count? Please help. Thanks. A: This is a very confusing issue, and it is very difficult to sort out. The bottom line is that all the top lasers are very good, and different doctors will choose different lasers for a multitude of reasons. I suggest that you choose the doctor that you like, and then go with his/her choice of laser. Andrew Caster, MD www.CasterVision.com

Email: August 02, 2006 Q: I had lasik one week ago today. I paid $5000. I opened up the morning paper and my doctor has an ad for a summer special for $2800 (there is no mention of certain exceptions). What is interesting is that I had my one week check up yesterday and the office manager mentioned to me that for my 19 year old it would only cost 2800 because it is cheaper if you are under 25 years old. Is this all just a sales pitch? A: Yes, just a sales pitch. It is the same work regardless of the age. Andrew Caster, MD

Email: August 04, 2006 Q: I am considering having LASIK performed in the next few weeks. I had read that the Intralase procedure was superior to the microkeratome (sp?). However, I consulted a different doctor that doesn't offer Intralase and...(email cut-off) A: I do not think there is a difference that makes IntraLase or the microkeratome better than the other. Andrew Caster, MD

Email: August 04, 2006 Q: I have optical neuritis, will lasik sugery fix this problem or improve it? I have been to yes and no. Thank You!! A: Lasik will not fix optic neuritis. Andrew Caster, MD

Email: August 08, 2006 Q: My husband recently had laser eye surgery and since then he sees brite sparks and black shadows. My question is, the doctor that performed his lasik surgery tells him that it might be retinal tearing. He is only 35 and none of this started until after his surgery. Do you think maybe that has to do with the lasik? Thank you. A: No, it probably has nothing to do with the Lasik, but it should be looked into. Andrew Caster, MD

Email: August 11, 2006 Q: Hi Dr. Andrew, My question for you is this. I wear contacts and at my last eye exam, my doctor told me that because I wore my contact for a longer duration then maybe I was supposed to have, I had some deposits left on my eye as a result. Is that going to affect my candidacy for LASIK surgery? A: No, this should not affect your Lasik treatment. Andrew Caster, MD

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