Email: November 29, 2004 Q: Is there a possibility that after Lasik surgery the flap could reopen? A: Yes, trauma can reopen the flap. This is much more likely in the beginning. Andrew Caster, MD

Email: November 29, 2004 Q: If I have a Lattice Degeneration whats the best to way to get the LASIk done. A: If this is lattice degeneration of the retina, then see a retinal specialist prior to the lasik. If it is a corneal problem, then lasik may not be advised. Andrew Caster, MD

Email: November 30, 2004 Q: What is the difference between Custom LASIK and CustomVue Laser Vision Correction? I had Conventional LASIK in 1998. I had myopia and astigmatism. I am experiencing regression, i.e. I am definitely loosing my distant vision and I am also not seeing as clear close up. I saw a surgeon at TLC yesterday and was told that I would benefit from Custom LASIK in which my distant vision will be fixed, but I would need reading glasses for close up. Is this a resonable recommendation? What would my vision be like 10 years from now if I undergo the Custom LASIK procedure? Any comments about TLC Laser Center? Thank you for your time. Dr. Linda Yang, Covina, California A: CustomVue is the Visx brand of custom Lasik. Andrew Caster, MD

Email: December 02, 2004 Q: I am 55Year old male. have used corrective lenses to see far for many years, I have no other eye problems to my knowledge. I am a privete pilot and fly for recreation only. I like to read and make my living as a registered nurse. Is there an appropriate eye surgery for me that will still alow me to read and not interfere with FAA regulations,( no monovision)? than you A: No. Only monovision is possible at this time to correct distance and near in people over 50. Andrew Caster, MD

Email: December 02, 2004 Q: hi. my mum has had lasik eye surgery a few months ago. She has complications now in her eye which are recurrent epithelial regrowths of about 4 mm wide. she has had biopsies to clear them but they keep coming back. is Mitomycin C a good option at the moment? also what other sources may i contact, since her surgeon doent know too much about this medicine? also what concentration is it to be used at and how safe is it?thanks so much. A: I would get another opinion from an experienced Lasik surgeon. Andrew Caster, MD

Email: December 03, 2004 Q: Today I was undergoing a customvue monovision procedure. My doctor in my best interests decided to stop after a 5 to 10into making the flap because the flap was being cut to thin due to my flat corneas. He said he was confident that the procedure could be done but felt A different tool would be more successful in forming the flap. In your opinion can a flap be made successfully on a flat cornea. I have to wait a month or more now so my eye he started with can heal. I was very disappointed but happy that he took my well being into concideration first. Now I have one eye blood shot, covered till morning until when I see my doctor. I'm also having second thoughts on doing the procedure at all. Can I have any problems with just the percentage of the cornea thats been cut on already. If I choose not to have the Lasik can I still wear contacts on my right eye now that theirs been a slight cut on the cornea.Thank you, Linda A: You can certainly continue to wear contacts if you want to, but most likely a Lasik procedure can be performed safely after you heal. Andrew Caster, MD

Email: December 03, 2004 Q: I am preparing my FSA card for a All Laser Lasik with custom Wave front surgery in January. I am located in Southern California, and have narrowed down my choices to 2 surgeons: Thomas Tooma with TLC, and Charles Manger with Saddleback Eye. Both seem to have a great deal of experience in this field, I have seen lawsuits outstanding against both (most from 99 nothing new) The major difference is the type of laser they use. Tooma has the Alcon LadarVision laser and a Visx laser. I have heard the Alcon Ladar Vision laser provides better over all site and eliminates some of the night glare or Halo's. I currently have excellent night vision so this is a concern. Charles Manger uses the Visx laser. My question: Is there a signifigant difference between these lasers? Do you have a recommendation? Thanks! Erik C. Morley A: I like the Alcon laser, but there is not a large difference. Andrew Caster, MD Caster Eye Center Beverly HIlls, Ca.

Email: December 04, 2004 Q: I am scheduled for Lasik in a few days but for some reason am still very hesitant about the procedure. My vision is not too bad (-1.75 and -2.5 is my contact prescription) and I wear contacts most of the time. I am concerned about the possibility of something going wrong or the effects of the surgery 10-20 years from now. Am I being paranoid? The doctor I'm working with has performed Lasik on 3 good friends and they are all happy. Any words of wisdom for me? A: I would check out the credentials of the doctor. The quality of the doctor and the center that he works at are the most important factors in avoiding problems. Andrew Caster, MD

Email: December 05, 2004 Q: I heard that S. Korea has been doing LASIK procedures for longer and are just as experienced as US doctors. Can you tell me if this is true? What are the advantages/disadvantages of one country over the other? A: In general, the quality of care in the United States is the best in the world. Andrew Caster, MD

Email: December 06, 2004 Q: I just had consultations done at the Hauser-Ross Eye Institute in Sycamore, IL done. They thought up front that I would be a good candidate for the customvue procedure. I am not due to astigmatism falling out of the acceptable range. They said they could proceed with traditional lasix. I have a couple of questions.. 1. Dr. Ahn mentioned a new procedure that is not FSA approved yet that is better than customvue and that takes higher tolerances for astigmatism than customvue. He did not know when it would be approved or if I would be an ideal candidate but he said he needed to tell me all of my options. What do you think? 2. My prescription now is very near sighted and worse the -3 on both eyes in astigmatism-do you think the traditional lasik will work? 3. I have a vertical imbalance in one eye and wear a prism to correct that (glasses all my life, no contacts because I cannot stand things touching my eyes). What effect will this procedure have on my verical imbalance. Will i still have to wear a prism for that? Please let me know. Your feedback is greatly appreciated! A: The lasik does not affect the need for prism, so you will still need prism afterwards. I cannot comment on whether you are a good candidate for Lasik because I do not have all the information. Andrew Caster, MD

Email: December 08, 2004 Q: what is differnce between verisyse and cyrstal lens surgery?my husband is considiring c.lens surgery, cost at 2500. per eye is that about right,seems a little steep. A: Verisyse is a lens that is placed inside the eye. With CrystaLens, the natural lens inside the eye is removed and a new lens is placed. $2500 per eye is very low. Andrew Caster, MD

Email: December 09, 2004 Q: Hi, I would like to get clear answers on the following questions related to Lasik surgery, especially that I'm considering Lasik: 1- Since when is Lasik being done? 2-I have nearsightedness around -6.75 in left eye and 6.5 in my right eye. what would you estimate the correction percentage would be i.e. am i going to wear glasses after Lasik. 3- My doctor name is Johhnny Khoury, he's the only one that operates in American University of Beirut hospital and he is a diplomate from the American Board of Ohtalmology, do you think I should consider operating in the States as I have my Green card and can go there. Thanks a lot for your quick response. A: You are a candidate for Lasik based on your prescription. I do not know about your doctor. Andrew Caster, MD

Email: December 09, 2004 Q: if I'm 49 and 6.75 vison 3.75 sig would you correct to 6.0 and if so what would you charge I'm fullerton ca thank you Demetrius A: It would be best to call our office at 310-274-1221 to discuss all the issues. Andrew Caster, MD

Email: December 09, 2004 Q: I am curently in the military and I am on the wait list for LASIK but its about four years. My eyes over the last few years have become worst, should i wait to have LASIK or just do it now? I'm 20 male/ good health A: Lasik will not stop the eyes from changing. We like to see 2 years without change to be sure that the eyes have stabilized. Andrew Caster, MD

Email: December 09, 2004 Q: I am male 39 yrs, nearsighted [-2.75 both eyes], and my contact prescription has not changed much in 3 or 4 years. Should I expect to have to do Lasik surgery more than once? More frequently as I age? Can I go back to glasses if my vision worsens later? Thanks A: For most people, the results of Lasik will be permanent and no further Lasik will be needed. Andrew Caster, MD

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