Q: Why is LASIK surgery so controversial? What are the negative outcomes of it? The information you provide will be used in a collage research paper! Your credentials will also be requested. Thank You A: There is extensive information on my website, www.castervision.com. Andrew Caster, MD

Q:  How long do the effects of custom (wavefront) lasik last? Is the vision loss progressive as you get older? Would it progress back to what my presciption is now or will the worst case senario still be better than my presciption now? A: The results are permanent, but will not stop the naturally occurring changes in your eyes. Andrew Caster, MD

Q: Hi! I read an article about someone in the paper(lost copy) who had lasik surgery but it was more advanced than 20/20. It cost more but gives you eyesight like that of a bird of prey?? Please tell me or do you know what this surgery is called Thanks kindly, Gary A: It goes by the general name of wavefront, though sometimes it is referred to as Custom surgery. Andrew Caster, MD

Q: Does intralase cause presbyopia or accelerate it? I am 30 yrs old, have a minor form of astigmatism and near sightedness. While I have successfully passed the eye screening testing and am a good candidate, another reputable doctor advised me not to do the Lasik as it would make me need reading glasses and could impair my close up vision which is near perfect. Is this true? Help, my surgery is scheduled for March 21 on the East Coast. Thanks tons!! A: Intralase or any other form of Lasik does not cause presbyopia or speed it up. Anyone who has excellent distance vision who is 45 or older has some presbyopia and has some trouble seeing up close. If you have on glasses or contacts to see far away, you can take them off to see up close, which is something that you cannot do if you have your distance correction fixed with Lasik and no onger wear glasses or contacts. Andrew Caster, MD

Q: Had Lasik done March 5...From a minus 6.50. Vision received was approx 20/25. After only one month, vision regression has me back to approx minus 1.50....What are causes, what is prospect in future...Do I have future procedure at 3 Months out or will same thing happen? A: We don't know why some people have a regression. It is less likely that it will happen after your enhancement. Andrew Caster, MD

Q: Monday (this 14th) I am having Wavefront Lasik at TLC here in St. Louis as many people ay my work have had this done 1 just a week ago and have nothing but terrific things to say about Lasik and TLC. I am 37 now and have worn Acuview 2 week contacts for 17 years (-3.75 and -4.00) which has stayed the same for 17 years. BUT when I was 16 I had Keratoconus and keratius (at the same time) Very blinded by light with my poor eyes looking like they were bleeding. Had to wear glasses then, RGP lenses for a couple of years and then the Acuviews. While my corneas are steep (8.4), they are as thick as they need to be (4.70 and 6.03) so the Dr. felt that he could see where someone might think I had keratoconus becuase of the irregular shape in the left eye and my steep corneas. He did not think that I had had it or that if I did I had a very mild case that was caught quickly. I also want to know if the flap they cut heals up or remains loose forever since they do not use stitches. So any thoughts? The info on the proceedures on the web are VERY conflicting and there is virtually no info about those diseases and Custom Lasik out that I can find. Any help or thoughts would be most welcomed! I must say the Dr. himself re-perform some tests. I did feel like he was looking for any reason that the proceedure could not be done - since I told him right off the bat about the illnesses and first thing he said was that Lasik - Wave front or other wise - was absolutly conterindicated in keratoconus people. And they have a very expensive machine that specifically looks for the disease - and while me left cornea was irregular - it was not thinned out as it would be with the disease. Much thanks for any advice - Jennifer A: Kerotoconus does not go away. But the diagonosis of keratoconus could have been wrong many years ago. If in doubt, get a second opinion. Andrew Caster, MD

Q: I am based in the UK. I had the test to see whether I am a candidate for Lasik/Lasek yesterday. When they put the anaesthetic drops in they said I had had a reaction and that the epithelium cells had "broken up". They said this was very rare. They were unable to measure my corneal thickness so they are going to do this next week using different drops. The doctor said the drops used first had probably been too "toxic" for my eyes. My question is whether this is going to affect my suitability for lasik/lasek? Many thanks Mimi A: Ity may. It may be better for you to have Lasek rather than Lasik. Andrew Caster, MD

Q: I have macular degeneration in my right eye. Is it ok to still get lasik treatment? A: Yes, but depending on how bad the macular degeneration is, your result will be limited as far as the final vision is concerned. Andrew Caster, MD

Q: I had Lasik on both eyes 2/17/05. Using both Intralase and CustomCornea. The results gave me great distance but very poor near. Expecting this to get better over time, today my vision is blurry and hazy. My near vision requires me to wear reading glasses for anything less than 8 ft away. My contacts gave me better vision. My next follow up isn't until 4/8/05. I am concerned. If I had my contacts on right now, I would have taken them out and wore my glasses, now I don't have that luxury. Drops have not helped today. Again, up until today, my distant vision wasn't blurry, just now my near is awful. I am 44 yrs old but was I to wear reading glasses for everything? A: Go back to see your doctor sooner, and pose these questions. You may need an enhancement. Andrew Caster, MD

Q: Dear Sir, I have been experiencing some flashes in the corner of my right eye. It kinda reminds me of a lightening flash. This happens once in awhile. What would be causing this. It began about two or three months ago. I am 72 years of age and have been wearing glasses 40 years. Thank you. Mary A: It is due to traction on the retina. Usually it is not serious, but you should see an ophthalmologist. Andrew Caster, MD