Q: Hello doctor.Iam Dr.nikki here.i will be very thankful to u if u reply my question. my friend who underwent lasik procedure about 3 years back has developed a complication now .Her DOCTOR says that she has started developing KERATOCONUS.it is a very recently known complication of lasik.is it true?if so who are the patients who may land up in this problem and also please tell me how to avoid this grave problem if one has already undergone lasik surgery .THANK YOU. A: Keratoconus can occur with or without Lasik. The treatment is to wear contact lenses. Andrew Caster, MD

Q:  Dear Dr. Caster, I am myopia/astigmatic (OD -6.00 -0.50/OS -5.50 -0.5) and my cornea thickness is right->498um/left->489um. Can LASIK give me 20/20 vision and still leave enough cornea thickness if I need an enhancement ? Or, should I pursue other refractive surgery ? Regards, Kevin A: Depoending on several additional factors, you may be able to have lasik, or PRK may be your best option. Andrew Caster, MD

Q: I had lasik in August - prior to lasik my vision was about -6.50 both eyes; after lasik until apx 1 month ago, my vision was great, now my near vision is great, but I have lost distance such that I must squint to see anything with distinction about 15-30 feet away. Should I have an enhancement? A: Maybe. You should see your doctor for an evaluation. Andrew Caster, MD

Q: I had Lasik surgery in June 2002 and still experience significant "starbursts" from light at night. My vision is about 20/25 and my cornea is relatively thin (480 after lasik). Can any of the new procedures (such as CustomVue Wavefront) be used to eliminate the starbursting for my situation? A: Yes. You should obtain another evaluation. Andrew Caster, MD

Q: I know it says that you must remove your soft contact lenses upto 4 days prior to measurements. Is that for Custom Lasik or Standard Lasik? Also, what if you were to pop in your contacts for periodic time frames during that 4 day window. What would be the ramifications? A: The exact amount of time that you should be out of your contacts is not clear. Some doctors say 7 or even 14 days. The ocntacts can affect the measurements. Andrew Caster, MD

Q: Hello! I'm 34 years old and had LASIK in 1999, but my vision seems to be getting bad again. I'm wondering if any of the laser eye surgeries are appropriate for someone who's already had LASIK? Thanks! A: Yes, Lasik can be done again. Andrew Caster, MD

Q: I have gotten a free LASIK evaluation before and was told that I was not a good candidate because my maximum correctable vision was 20/40 and that with LASIK, that can sometimes get worse. Do you feel that LASIK is an option for me? If not, what is the possibility of a lens transplant? I think that is a possible solution, which would correct where the visual image is focused. Thank you for your reply. A: I would need to see your exact situation in more detail, but in general we recommend against any elective surgery in people who can obtain only 20/40 vision even with glasses. Andrew Caster, MD

Q: If I have LASIK or LASEK surgery performed and my eyesight becomes worse years later, will I still be able to wear contacts after the surgery or would I have to have another surgical procedure performed to correct my vision. Currently I wear -8 lenses and also need +2 for reading, if this makes a difference. Thanks. A: Almost all of the time, if your eyes change in the future and you need visual correction, then you can wear contacts if you choose. Andrew Caster, MD

Q: I am 40 wks pregnant and for the second time ever, my vision has gone awry. I have a severe astigmatism w/ soft lenses -4.75. It is as though there is gasoline in the air and is making everything wavy. (even w/ my eyes closed.) Difficulty focusing, definite light headedness, but horribly affected vision. This has happened recently with contacts on, and today with glasses. Is this directly related to the pregnancy? Last month when it happened it lasted almost an hour. What should I do? A: You should see an ophthalmologist immediately.There may be a serious problem that needs attention. Andrew Caster, MD

Q:  I¿m nineteen and I have amblyopia. I know it¿s harder to treat adults with amblyopia, but can laser eye surgery improve my vision? If it is possible, is there also hope of straightening my lazy eye? I¿ve had two surgeries with no success. I know this problem isn¿t as severe as other eye conditions. I¿m very thankful to have one functioning eye, but I¿m tired of explaining to people why I have a ¿weird eye,¿ the headaches, and the eyestrain. A: You may be able to have another surgery to straighten the eye, but the amblyopia cannot be fixed at this time. Andrew Caster, MD