Q: I scar badly (keloid). Would this limit my options in Lasik surgery? Is there any research on the surgery on people who don't scar well? Thanks for your help. A: People who scar badly, forming keloids, do not have a problem with Lasik. The cornea reacts differently than the skin. Andrew Caster, MD

Q:  Greetings, On 27 July, I had intralase / lasik surgery. While the right eye went well, the intralase procedure on the left eye failed to completely seperate the flap. Specifically, the flap was still attached in the vicinity of the pupil. The surgeon was unable to successfully lift the flap and complete the procedure without risk of tearing. I am now in recovery and have been told that I should pursue PRK in a few months. Question 1: My surgeon has extensive experience with laser eye surgery (over 18,000 operations) and states that this is the first time he has seen this occur with intralase. Do you have any statistics relating the occurence of this anomonly with intralase and any insight as to the root cause of the failure. 2. Do you agree with the recommendation that I proceed with PRK once the eye has healed or is there a better approach? A: This is very rare. I am not surprised that this is the first time that it has happened. I have not had this problem yet, but eventually it will happen. I agree that you should have PRK. You should have an excellent result and be very happy. Andrew Caster, MD

Q: My Dr. says my cornea is too thin for lasik, he says you need 250? and I have 272. He's on the conservative side and feels prk would be a better choice. What do you think? I like the idea of a quicker recovery time. A: I would recommend PRK in your case. Andrew Caster, MD

Q: I am 22 and have very poor vision (about -8.00 in each eye). Is my vision too bad to get surgery ? How bad can my vision be and still be able to get the sugery done? A: Usually, laser vision correction is available for -8.00. Andrew Caster, MD

Q: I have been told that I have thin corneas (510)so I am not a candidate for LASIK. I also have steep corneas (-6) I am however a candidate for PRK. One doc said I should not have the custom vue procedure done because of the thin corneas. One doc said I can have the custom vue done. Both use the LADARVISION. Who do I trust? A: It is often difficult when you receive differing opinions from two different doctors. This happens because there are no clear-cut answers to certain questions, so different doctors can have different opinions about what is best. Which doctor do you innately trust more to make the most informed decision? Look to education, reputation, and a sense of caring. Andrew Caster, MD

Q:  I'm 34 years old and have been told by my opthalmologist that I'm a good candidate for Lasik. My extensive eye exam will be done in August. I'm quite nearsighted. I don't know my exact prescription but it's around - 6.5 and a little more in the other eye. I'm very scared about having complications postop and losing my eye sight completely. That is my worst nightmare coming true. Any comforting thoughts or your honest opinion about my fears. Am I right to be so apprehensive. Your opinion will be greatly appreciated. A: I have never heard of a patient losing their eyesight completely from laser vision correction. I assume that it is possible, but I am not aware of even a single instance of this happening. Andrew Caster, MD

Q: Hi, can I wear contact lenses for cosmetic reasons after doing the LASIK surgery? A: Yes, you can wear cosmetic contacts after Lasik. Andrew Caster, MD

Q: After getting PRK are your chances higher for needing reading glasses? I thought I read that somewhere.........that later on in life when you are older your chances of needing glasses for seeing up close increase. Is this true? Is it a definite or just a small possibility? (I know it's natural at a certain age to need reading glasses anyway). Thanks. A:  Any person who has good distance vision in both eyes -- either because they wear contact lenses, have laser vision correction, or wear glasses for distance -- will have trouble with near vision starting on average around age 45. Laser vision correction does not change this at all. If you wear glasses, then you can get bifocals. If you wear contacts or have laser vision correction, then you can use reading glasses when needed. However, people who are nearsighted and who use glasses or contacts can remove the glasses or contacts and they will have close up vision, depending on their prescription and age. Andrew Caster, MD

Q: I got my LASIK eye surgery done 5 weeks before. My left eye is perfect (20/20), but I am not even able to read the first E in the eye chart with my right eye. I was told that my right eye should heal and it may take up to a max of 6 months. Can you please advise me on this. Thanks. Narmada A: I would obtain a second opinion to determine exactly what is going on. Andrew Caster, MD

Q: I am having lasik surgery done on both my eyes tomorrow with Drs. Rose in Costa Mesa, CA. I have been told that I have slight dry eyes (which has made wearing contacts awful). I have been taking flax seed oil and using sustain eye drops for the last week to help. Do I have a high chance of having severe dry eyes after lasik? Will they be uncomfortable? My doctor did not mention any risk of severe dry eye after lasik to me, so I am guessing that isn't a concern? Any advice would be great! Thanks, Hillary A: Dry eyes are a concern after lasik, and are more of a concern in people who already have dry eyes. The key question is: how dry are your eyes without any contact lenses? If they are dry without contact lenses, then you should consider having "lasik without the flap", as this is much less likely to worsen the feelings of dryness. Andrew Caster, MD