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

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

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

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

Q: Hi Dr. Andrew, My question for you is this. I wear contacts and at my last eye exam, my doctor told me that because I wore my contact for a longer duration then maybe I was supposed to have, I had some deposits left on my eye as a result. Is that going to affect my candidacy for LASIK surgery? A: No, this should not affect your Lasik treatment. Andrew Caster, MD

Q: My husband recently had laser eye surgery and since then he sees brite sparks and black shadows. My question is, the doctor that performed his lasik surgery tells him that it might be retinal tearing. He is only 35 and none of this started until after his surgery. Do you think maybe that has to do with the lasik? Thank you. A: No, it probably has nothing to do with the Lasik, but it should be looked into. Andrew Caster, MD

Q: I have optical neuritis, will lasik sugery fix this problem or improve it? I have been to yes and no. Thank You!! A: Lasik will not fix optic neuritis. Andrew Caster, MD

Q: I am considering having LASIK performed in the next few weeks. I had read that the Intralase procedure was superior to the microkeratome (sp?). However, I consulted a different doctor that doesn't offer Intralase and...(email cut-off) A: I do not think there is a difference that makes IntraLase or the microkeratome better than the other. Andrew Caster, MD

Q: I had lasik one week ago today. I paid $5000. I opened up the morning paper and my doctor has an ad for a summer special for $2800 (there is no mention of certain exceptions). What is interesting is that I had my one week check up yesterday and the office manager mentioned to me that for my 19 year old it would only cost 2800 because it is cheaper if you are under 25 years old. Is this all just a sales pitch? A: Yes, just a sales pitch. It is the same work regardless of the age. Andrew Caster, MD

Q: What are the reasons that a patient or a doctor would use the Allegretto Wave over the VISX w/customvue? The Allegretto reports that 87 of patients see 20/20 one year after surgery and VISX S4 Customvue reports that 98 of patients see 20/20 one year after surgery. There must be a reason since many top docs have chosen Allegretto. The "top" doctor in my area (highest volume, best marketing) uses Allegretto but there are a few great doctors in the area with tons of experience that use the VISX w/customvue. Also, my pupils dilate to 7.5mm and 7.6mm in low light. Allegretto is 4.5mm-8.0mm optical and VISX is 6 with a transition to 9mm. Is the ablation zone large enough to reduce the chances of night halos for me? Does that mean one is better for Halos? Allegretto doesn’t use wavefront and customvue does? Is it not important? Why would a top doc get a laser that doesn’t have wavefront? Does the optical zone have to be larger than my pupil size or does the "transition zone" count? Please help. Thanks. A: This is a very confusing issue, and it is very difficult to sort out. The bottom line is that all the top lasers are very good, and different doctors will choose different lasers for a multitude of reasons. I suggest that you choose the doctor that you like, and then go with his/her choice of laser. Andrew Caster, MD www.CasterVision.com