Email: November 12, 2004 Q: I had custome vue (monovision)about 6 weeks ago. The eye for distance does not have the vision I had after the surgery. Night and dim lighting is really hard to see. my near vision is good/clear as long as I have some light. Is this normal? also I was put on vytorin on 11/2/04 and my eyes are dryer.Is that normal? thanks A: Thee is definitely a healing period that takes 3-6 months. However, you may not have obtained the exact required result and may need an enhancement. Andrew Caster, MD

Email: November 12, 2004 Q: I live in Ireland but I hope you can answer this question. Would it be standard practice for a surgeon to deliberately undercorrect the vision in one eye during Lasik surgery? The reason given was that at age 42 it would help my reading vision going forward. There is a substantial difference between my two eyes as my other eye is perfect. Thank you for your help. Deirdre O'Brien Galway Ireland A: I believe that the patient should be given a choice to have this done and that it should only be done if the patient chooses. Andrew Caster, MD

Email: November 13, 2004 Q: I had lasik surgery 2 years ago next week. I have had 2 enhancements on my left eye ( I have mono vision and this is my distance eye. Each enhancement has worsened my vision. I have sever halos, poor night vision, 20-60 distance vision and an after image. I have epideral cells under the flap and a wrinkle. My vision in this eye is not clear at any range. At the recommendation of another specialist, my doctor bathed the eye with an alchohol solution to try to kill the epithelium. Now he is recommending a third lasik treatment. I think I am starting to lose the flap and am afraid to have it lifted again. I have .50 micrometers ( I think micrometer is the measuring unit) and he thinks .10 will be all that I will lose leaving me opportunity for other treatments should they be necessary. I am scared to death. Do you know any one who specializes in repair of Lasik-gone-bad? I am not blaming my doctor. I knew there were risks going into this but I don't want to run out of options if there is someone with more expertise in problems with lasik than my doctor A: I would carefully look around and get a second opinion. Andrew Caster, MD

Email: November 13, 2004 Q: after lasik surgery,will there be any chances of wearing glassess again.i'm shortsighted with 250 both eye. A: Yes, there is a very small chance of still needing glasses. Also, if you are over 45, then readers will be needed. Andrew Caster, MD

Email: November 14, 2004 Q: Could a person's natural eye color be changed by using color lenses for laser correcitve surgery? A: Lasik cannot change the color of the eye. Andrew Caster, MD

Email: November 14, 2004 Q: My husband is interested in lasik and is a candidate. All the information received shows results at one year. What are the long term results? He is now 42 will he ever have to wear glasses again if at one year he has good vision?How far post op is there data on effectiveness? Are there any articles on long term results I can access via the internet? A: There are long term studies which show stability after the first year. A few patients will have a change in the vision, but a few percent of people who don't have this surgery will also change as well. So Lasik does not stop naturally occuring changes in the future. Also, readers will be needed, usually around age 45, whether or not Lasik is performed. Andrew Caster, MD

Email: November 15, 2004 Q: Hello Doctor, My name is Vishal. I am interested in getting a LASIK procedure done at your institute. I am Myopic since birth. I currently use contact lenses of -13.5 spherical with -2.5 cylindrical in prescription. I wanted to know what the investigative suitability procedures are for getting LASIK done. Is it safe to get the full defect corrected, as I have heard that at such a high power the lenses are streched and thin as it is and further removal of tissue from it would weaken it. Also how long would all the investigative procedures take to be done? Also if you are please able to send me some literature in relation to the procedure, I would be grateful. Thanks in advance Vishal A: We do not perform Lasik on that prescription. The phakic intraocular lens is the best solution. Andrew Caster, MD

Email: November 15, 2004 Q: Hi, I am wanting to get Lasik and I had a new eye exam a couple months ago, I wear my contacts a lot more than my glasses so when I had my new exam I only bought contacts, I have to wear my glasses from my last exam for a week before I go to my appointment, my vision only changed a little, will this interfere with the Lasik, Thanks A: No. Andrew Caster, MD

Email: November 15, 2004 Q: Sorry for the limited information, but I was wondering if it is possible for a person with Right: sphere +6.00, cyl. -1.25, axis 020, prism 4.5 base BO & Left sphere +7.25, cyl. -1.75, axis 165, prism 4.5, base BO vision to get LASIK. Is it possible? Will i still have to wear a lessened prescription afterwards? I am just trying to research all of my possible options. I appreciate all of your assistance on this matter. A: Lasik will not provide a full correction. Andrew Caster, MD

Email: November 16, 2004 Q: Before I had the lasik procedure done, my vision was 20/450. I had the surgery done in July 2004. on November 9my vision was 20/25 and 20/30. Because the vision was noticably blurry in my 20'30 eye, my surgeon and I decided to correct this eye. I had the surgery done 6 days ago. Since the day of my surgery my vision has been 20/100.I have not noticed one ounce of change in my vision since the day of my surgery. I am so worried! Why did my vision regress so much? and will it ever reach 20/20? please contact me ASAP. my worse nightmare has happened! I HAVE ALSO HEARD THAT YOU CAN ONLY HAVE LASIK SURGERY DONE TWICE WITH OUT HARMING YOUR EYES. IS THIS TRUE? A: There is no limit to how many times you can have Lasik, except that a certain degree of thickness must be maintained. Your eyes are still healing, so I would not be overly worried at this time. Andrew Caster, MD

Email: November 16, 2004 Q: I am a 34 year old writer who is has myopia (-2.75/-3.00) and have been considering laser surgery. However, because nearly all my work is close up, and because my close vision is near on perfect, would you recommend I take the risk of surgery? I have heard that sometimes, when myopia is corrected, far-sightedness then occurs. Although I would like to be free of glasses and contacts, it is better that I am short sighted than long sighted for the work I do. A: You are well below the presbyopic age, which is 40-50, but that is in your future. After Lasik, at least until you get presbyopia, you should see up close as you do now ith your contacts or glasses on. Andrew Caster, MD

Email: November 16, 2004 Q: I've had the Intra-Lase Lasik surgery about a week ago, but now see some acute "shadowing" of objects (three golf balls in flight, for example, when there's really only one in the air)--and the typical "haloing" of lights...are these typical, and how long are they supposed to last in typical situations before I should get concerned? A: These could last for several months. Andrew Caster, MD

Email: November 16, 2004 Q: My eye doctor, that I've been going to for years recommends I wait to get corrective surgery done because my prescription is really high (-6.25) that if I get LASIK done, I still may have to wear a low power of glasses. Is this true? If this is true, is there a procedure coming soon to correct high levels of nearsidedness? Thank you A: Your prescription is fairly typical for Lasik patients, so I do not think that you are getting accurate information from your doctor. Andrew Caster, MD

Email: November 17, 2004 Q: hello, i am doing a science fair project on eye sight and i was wondering how far away from the eye chart (in distance like feet etc) must you be to begin testing your eye sight? thank you sincerely, Jessica Nielsen A: The usual testing distance is 20 feet (or 6 meters in metric countries). Andrew Caster, MD

Email: November 17, 2004 Q: Dr. Caster, Are there any disadvantages to having the Customvue Lasik procedure over the traditional Lasik? I recently went to 2 different information sessions and one gave me the ¿Why wouldn¿t we give our patients the most up-to-date technology¿ spiel and one gave me the ¿We wouldn¿t feel ethical charging you for something you don¿t need¿ argument. I don¿t mind paying a little more to ensure the best for my eyes. My pupil size is 7.5 and my vision is ¿2.25. Thanks! A: Custom Vue is a little better, particularly regarding vision in lower light. Andrew Caster, MD

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