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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:
August 14, 2006 Q: I am considering Lasik but I heard that even though the procedure might be successful, I might have to redo it in about 3-4 years. I wanted to know if this is a one time thing, or is it something that has to be repeated at certain periods of time? A: Lasik will not stop any naturally occuring changes in your eyes, so you should wait until most of the the changes have occurred in your prescription before you have Lasik. In most people this is by the early 20s. The results of Lasik are permanent, so only a small percentage of people will need further treatment. Andrew Caster, MD Email: August 15, 2006 Q: I was diagnosed five years ago with undifferentiated connective tissue disorder after going through many infertility treatments and having two miscarriages. I have been on plaquenil and mobic since then. I have no symptoms and the rheumatologist has kept me on these meds as prevention since I had a positive ANA and a mom with lupus. I can stop the meds without any sideffects. Does this disease disqualify me for surgery? Thank you, Angela B. A: The current feeling among many Lasik specialists is that autoimmune connective tissue disorders are not a disqualifying factor for laser vision correction as long as the disease is quiet and under control. You would not have to stop the medication. Andrew Caster, MD Email: August 18, 2006 Q: Do you think intralase is a safer option for the patient who has slightly dry eyes and a slightly flat (but adequate thickness)cornea? A: I do not think that there is any difference in safety between IntraLase and the other modern keratomes. Each company seems to have studies that show that their machine is the safest, but I think that they are all extremely safe and essentially equivalent. Andrew Caster, MD Email: August 30, 2006 Q:
I would like to get Lasik but I have two worries.
1. I have dry eyes, not severe but I have problems wearing contacts so I use glasses, how bad could this be? 2. I have heard that the lens flap with Lasik will never 100 percent re-attach and that only 10 percent at best will reattach, is this true and what problem could I face long term? A:
The general rule about dryness is that, after Lasik, you will have dryness similar to the dryness that you have with your glasses. In rare cases, there may be more dryness than this, but that would be rare and is usually well treated with drops or pills. The flap is well healed to the degree that it is very difficult to move after a few months. A doctor, however, can find the edge of the flap and separate the layers in order to lift the flap several years later, which is to our great advantage, because that can make an enhancement treatment easier. Andrew Caster, MD Email: September 02, 2006 Q: I live in India. I consulted a doctor who advertised that his clinic has now launched - for the first time in this city -- “Customized Corneal Wave Front Guided Laser Treatment.” He said he has the “Schwind Excimer Laser” from Germany. He said this was the very best and latest instrument and conducts Advanced LASIK. He said I wouldn’t be able to get this advanced of a treatment even if I went to the US because this instrument hasn’t come to the US yet. My question is, is he telling the truth? Is the “Schwind Excimer Laser” really the best and latest instrument for LASIK? I have myopia of - 6 and - 7. He examined my eyes and said I was a good candidate for LASIK. He also said there would be no complications or any problems at all. I suspect he was not telling the truth here since I’ve read on the net there is always a risk of complications, and they could last for weeks after the procedure. I feel he glossed over all possible risks and complications - unless what he said is true, that this technology is now so developed that all risks and complications are now negligible. Is this the case? I’m nearly 34. he said everyone gets far sighted after the age of 40. I don’t want to undergo LASIK only to require reading glasses in another 6 years, so would it not be better if I were to wait until my 40’s to have LASIK? Because I figure by then the farsightedness might make my myopia diopters come down a number or 2, maybe to -5 and -6. I assume that’s the way it works, that becoming far sighted improves myopia/shortsightedness. And that the + numbers of farsightedness brings down the minus numbers of myopia. I assume I could then have LASIK that would give me perfect vision without my even needing reading glasses. I’m sorry to ask so many questions, but can you please help me? The problem in India is that even the most reputed doctors with the largest clinics can go disastrously wrong. And there’s no hope here of even getting any redressal from any consumer courts. A: Regardless of how perfect the equipment becomes, there will always be a risk of some complications, because we are dealing with living tissue. The Schwind laser is no better than the other top rated lasers; it, however, has not passed the United States FDA approval process and cannot be used in the USA. The farsightedness of middle age has really nothing to do with your nearsightedness. It is caused by the lens inside the eye getting stiff. If you have the procedure now, or in your 40s, or don't have it at all, you will still need reading glasses, unless you have monovision treatment. Andrew Caster, MD Email: September 04, 2006 Q: I am currently working over seas and plan on coming back to California for about a week. Is it possible to get what ever exams are needed and the LASIK surgery within that one week before I have to go back over seas? Thanks, A: Yes. We have many patients that travel to us from out of town. You should arrive the night before. On the next day we will perform the two sets of measurements and the treatment, and we will then see you the next day. You can fly on that day. You can contact us through our website www.castervision.com. Andrew Caster, MD Email: September 05, 2006 Q: Dr., Bob A: Personally, I believe that it is safe to enter the water after 2 weeks. However, I think that it is best that you follow the instructions of the doctor that you choose to perform your treatment. Andrew Caster, MD Email: September 09, 2006 Q: I would like to know if I am a candidate for Lasik surgery if I wear bifocals. A: You can have both eyes corrected for distance and then wear reading glasses, or you can have monovision, in which one eye is corrected for near and one eye for far. Testing will determine which works better for you. Andrew Caster, MD Email: September 11, 2006 Q: Hello Doctor, I have -14.0 myopia in both eyes. Which would be the most suitable vision correction procedure for me? A: The implantable contact lens (phakic intraocular lens) is the best treatment for you. Andrew Caster, MD Email: September 13, 2006 Q: I am 36 yrs. old ,got myopia of -2d in left eye and -3d in right eye .I am a known case of rheumatoid arthritis for last 3 years, on hydroxychloroquinine 200mg for 3 yrs., and methtrexate 10 mg for the last 3 months. A: It is probably best not to have laser vision correction until your condition is more quiet, without the need for the methotrexate. Andrew Caster, MD Email: September 13, 2006 Q: Hi dear, A: If your eyes are changing, it would be best to wait until your eyes have stabilized. In that way, you will be less likely to need an enhancement procedure in the future. Andrew Caster, MD Email: September 14, 2006 Q: I had PRK done on my eyes 11 years ago. My left eye corrected with monovision to 20/200. My dominant eye was corrected to 20/25. Since then, my eye with the monovision has gotten worse with the distant vision, from -2 to -3. I am having a hard time with distant vision even with my prescription eye glasses. Now I want my monovison eye to be corrected, could Lasik help me? The doctors I have called so far had refused to take patients whose eyes had been 'worked on' by other doctors. How do I find a doctor who will take up my case? A: Many of the most experienced doctors will take you as a patient. Lasik or PRK could be used to further correct your vision. Andrew Caster, MD Email: September 15, 2006 Q: I had lasik almost 5 months ago and my vision is a crisp 20/20 during the day. However, when its dark out, I get the worst glares off lights imaginable. My doctor thinks I may have high oder aberrations and prescribed drops to constrict my pupils. These drops have not really lessened the problems. However, my doctor is very much against additional surgery since I read the 20/20 line with no problem. However, I can't tolerate not being able to drive at night and do other activities at night. Do I have any chance of correcting my problems through additional surgery and should I seek out someone who is a professional in correcting lasik induced problems? A: I would get a second opinion. Further treatment may be in order. Andrew Caster, MD Email: September 15, 2006 Q: I would like to know if I am a good candidate for LASIK or if any of the information below represents contraindications. 52-yr. old male OD: -5.25, -1.25 x 173 deg. Schirmer's Test: 4mm each eye. Colvard Pupillometer: 4mm each eye. Orbscan pachymetry: 643, 599, 636, 645, 595 (center): thinnest = 585 microns. I'm especially concerned about the low Schirmer's test result (4mm) and also about my small pupils. I read in the VISX literature that the safety of LASIK (using the VISX excimer with CustomVue) performed on pupils smaller than 6mm has not been evaluated. I also read that dilating the pupils can affect the accuracy of a CustomVue scan. A: Your Schirmer's test is a little low. You should consider PRK as a possible alternative to Lasik. Small pupils can limit the ability to perform wavefront on some laser systems; other lasers can perform wavefront on eyes with naturally small pupils, because they are designed to have the treatment with the pupils dilated. Andrew Caster, MD Email: September 18, 2006 Q: Approximately 8 months ago I had surgery to repair a detached retina in my left eye. The surgery entailed a sceleral buckel (Sp) procedure as well as laser treatment to produce scar tissue to hold the retina in place. In addition they injected a gas bubble to also help hold the retina in place while the scar tissue developed. Although it appears that the retina has held in place the surgery resulted in producing considerable myopia in the affected eye. In addition I have considerable number of floaters which also negatively affects my vision in that eye. Iam wondering if Lasik might be a possible procedure to consider for improving my vision. Thank you , Jeff R. A: Lasik could be used to improve the myopia, but it will not improve the floaters. There is no acceptable treatment for the floaters. Andrew Caster, MD More
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