LASIK Eye Surgery Questions and Answers Archive

Aug
2000

Q&A: Should I consider enhancement surgery if my vision has regressed several months post LASIK eye surgery?

Question:

Dear Doctor, I had lasik performed one year ago. I was 20/20 but after several months I have now regressed to over -1 in the right eye & -2 in left eye because I had that eye done for close up. Im 56. I have very poor night vision. Need glasses all the time now at night, watching tv, driving etc. Not sure I would do the left eye for close up again. Of the patients you have done that for, are most of them happy with it? Do you recommend it? I didn't want to wear reading glasses all the time. I am considering an enhancement. Can you tell me are there greater risks on a 2nd surgery i.e. scar tissue after 2 cuts, your eye being more fragile etc. I was very nearsighted, -6, could that be why I would have regressed?? Do most doctors do the enhancement at no charge? Also what is this double carding I have been hearing about?? Would I have had that?? Thank you, JoAnn Richardson

Answer:

 Byron Stratas, M.D., F.A.C.S. - LocateADoc.com

Enhancements are usually part of the original fee unless you went to a discount lasik center. The risk is similar to the original procedure. You may want to enhance your dominant eye irst. Then, if you do not like the monovision, have the other eye enhanced and start wearing full time reading glasses. In most cases double carding should be considered as second rate, poor surgical planning. Double carding is a bad way to do what the more advanced software can do better.

-- Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina



Sep
2000

Q&A: How does the new LASIK software help farsightedness with astigmatism?

Question:

Could you give me info(how is it different from other lasik procedures) on this new lasik software for people who have farsightedness with astigmatism and when is it expected to pass through the FDA.

- jodie

Answer:

Andrew Caster, MD, FACS - LocateADoc.com

This new software isexpected to be available this month for the Autonomous LADARVision laser and within a few months for the VISX laser. The software directs the laser on how to move the laser light. Farsightedness with astigmatism requires a different pattern than farsightedness or astigmatism alone, both of which have already been approved by the FDA. 

--Andrew Caster, MD, FACS
Beverly Hills, California



Aug
2000

Q&A: How often and under what circumstances does a patient need follow-up surgery after having LASIK?

Question:

Many of the questions I read regarding Lasik Surgery elude that the patient may need follow-up surgery after the initial surgery. How often and under what cicumstances does a patient need follow-up surgery?

- Rick

Answer:

Byron Stratas, M.D., F.A.C.S. - LocateADoc.com

It depends on who does the surgery. In our practice the average enhancement rate is under 5%. However their are some patient types that have different rates.

--Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina



Aug
2000

Q&A: How long after initially having LASIK would an enhancement be or not be needed?

Question:

Hi, I have heard that after around 20 or so years an enhancement is needed, else the myopia will return. Is it true? Or is an once-in-lifetime laser vision correction sufficient for an eternal 20/20 sight? thank you!

- Krystina

Answer:

Byron Stratas, M.D., F.A.C.S. - LocateADoc.com

LASIK has been performed for about ten years worldwide and five years in this country. Therefor our followup is limited. Most of our patients are essentially unchanged. There may be some that fluctuate less than 5% from their early post op results but this is usually clinically insignificant. The bottom line is that there are no good studies to evaluate long term stability. Finally, LASIK doesn't give you a new eye. If you were going to have problems later in life, LASIK does not change that.

--Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina



Aug
2000

Q&A: Could I feel a pulling pain in one eye because I had an enhancement in that eye and I have not had the enhancement in the other eye yet?

Question:

I had lasik done on both eyes in april. Then an enhancement on my right eye in june. I see well out my right eye, but it hurts, it feels like there is something pulling. I am getting ready to have an enhancement on the left eye 8-24-00, so there is alot of difference in how the two eyes see. Could this be why I feel the pulling and will it stop after the left eye is enhanced?

- Paula

Answer:

Byron Stratas, M.D., F.A.C.S. - LocateADoc.com

Yes and maybe. Let us know how you do after the second eye is enhanced.

--Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina



Aug
2000

Q&A: Am I a good candidate for LASIK?

Question:

Am I a good canidate for LASIK, I'm 35 my right eye SPH -5.25 CYL-1.75 axis 155 & DIA 14.5. left eye SPH-6.00 CYL-1.00 axis 030 & DIA 14.5 for toric soft lenses. Also does correction for Astigmtisim cost more, the same?

 

 

- craig

Answer:

Andrew Caster, MD, FACS - LocateADoc.com

Dear Craig, Having the proper prescription is only one factor in determining appropriateness of the procedure. But good news, you have an appropriate prescription. Other factors involve corneal thickness and curvature, as well as several health aspects of the eyes. Andrew Caster, MD

--Andrew Caster, MD, FACS
Beverly Hills, California



Jul
2000

Q&A: At the age of 6, I had a thorn pierce my right cornea leaving a scar. How would this affect my eligibility for laser correction?

Question:

At the age of 6, I had a thorn pierce my right cornea leaving a scar. How would this affect my elegibility for laser correction?

- Heather

Answer:

Calvin Sprik, M.D. - LocateADoc.com

Heather, the scar on your cornea could effect your eligibility to have LASIK. It is difficult for me to tell you if you are a candidate or not without seeing the scar. i recommend you go and see a local eye doctor who does the LASIK procedure, and he/she can tell you if you are a candidate or not.

--Calvin Sprik, M.D.
Stevens Point, Wisconsin



Jul
2000

Q&A: What can be done if I received over-correction from LASIK eye surgery?

Question:

Thank you for responding, Dr. Stratas. My question continues... I had the lasik done the second time on my right eye eliminating the double vision and allowing me to see about 20/50 on good days with shadowing and the spokes and halos at night and dryness. The cornea was over-corrected in the first attempt and after the second time which eliminated the double vision, the cornea is too thin to do anything more with it to help me see distance. The lens insertion and a gas permeable contact lens if needed after the lens insertion is what is suggested to help me see distance. A cornea transplant is also an option in the future to replace the scarred and wrinkled cornea that is causing my shadowing as the light bends through the dips and valleys and scarring. I know this entails a lot more followup care in the future but my sight is at stake. Is the custom ablation guided by a wavefront analysis something that will attempt to fix my cornea even if too much material was removed by the over-correction? I need more power for vision. Please reply.

- Carlos

Answer:

Byron Stratas, M.D., F.A.C.S. - LocateADoc.com

As I said before I would do nothing further at this time. Wait for wavefront guided treatments to be available. A corneal transplant is very serious. I would try the custom ablation first. Also, I would seek a second opinion.

--Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina



Jul
2000

Q&A: How can the custom-cornea technology help when the LASIK procedure over-corrected and my cornea is now too thin?

Question:

Thanks so much for your reply, Dr. Caster. God bless you. My question continues... I was over-corrected with the lasik initially leaving me with no reading ability and about 20/50 on good days with shadowing and the spokes and halos at night and dryness. If I now see without the double vision and need more power to see distance, my doctor wants to do the clear lens extraction and fit me with a rolled up plastic lens that is inserted into the eye like cataract patients get. This along with a gas permeable contact lens if needed after the lens is inserted would attempt to correct the dips and valleys in the scarred cornea when used with drops to fill in between the gas permeable contact lens and the cornea to help attain the distance vision I need. A cornea transplant is suggested in the future if I can't attain the desired vision with the lens insertion and the gas permeable contact lens. How can the custom-cornea technology help when the lasik procedure over-corrected and my cornea is too thin now for any further cornea work?

- Carlos

Answer:

Byron Stratas, M.D., F.A.C.S. - LocateADoc.com

Your situation is more complicated than I was aware of. Of your cornea is too thin for any further laser work, then you cannot have any more laser work. The clear lens extraction may be useful, but has certain drawbacks. Make sure that you discuss this with your doctor. Andrew Caster, MD

--Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina



Jul
2000

Q&A: What should I do if my doctor performed LASIK (double carding) and now wants to performance more surgery?

Question:

DEAR DOCTORS I HAD LASIK SURGERY 4 MONTHS AGO AND MY PRESCRIPTION WAS OD -2.00 +3.00 X 95 OS -1.75 +3.25 X 85 HYPEROPIC ASTIG? OR MIXED ASTIG? MY DOCTOR PERFORMED A DOUBLE PROCEDURE ON MY EYES (DOUBLE CARDING)WITH THE SUMMIT APEX PLUS) I AM CURRENTLY SEEING 20/50 AND MY DOCTOR IS CONSIDERING AN ENHANCEMENT (VERY SCARED) MY QUESTION IS WHY ARE SOME DOCS PEROFORMING DOUBLE CARDING AND SOME DOCS ARE WAITING FOR THE FDA APPROVAL OF HYP ASTIG TREATMENT? I FEEL LIKE I HAVE JUMPED THE GUN AND MADE A MISTAKE. I HAVE SOME ASTIG LEFT WITH SOME MYOPIA NOW. MY DOCTOR TO DATE HAS NOT PERFORMED A TOPO ON ME. ANY TYPE OF RESPONSE WOULD BE APPRECIATED. THANKS JO ANN CISSELL

Answer:

Byron Stratas, M.D., F.A.C.S. - LocateADoc.com

It is hard for me to believe that there are ophthalmologists who do not know that the bitoric treatments give a far superior visual result than "double carding." There are some cases when double carding may be appropriate, but this is the exception. In our practice the patient's best interest is our chief motivation for recomending procedure(s). We place patients with your refractive error on a list so we can treat them the way we would want to be treated. We are not desperate for surgery to do, and we are not motivated by our own economic considerations. I am sorry you are having an outcome that is less than what you could have had. I would go to another surgeon for the rest of your care.

--Byron Stratas, M.D., F.A.C.S.
Wilmington, North Carolina



Jul
2000

Q&A: Do less expensive lasik procedures mean lower quality in vision correction or is it the same as a more expensive procedure? What price range could I expect to see?

Question:

Do less expensive lasik procedures mean lower quality in vision correction or is it the same as a more expensive procedure? What price range is reasonable?

- Denise

Answer 1:

Alexandra Christine Chebil, MD, FRCSC - LocateADoc.com

Lasik eye surgery is like anything else- you usually get what you pay for. Discount laser centers usually hire doctors by the hour, and have much of your eye tests done by a "technician" or office assistant, not the actual surgeon who will correct your vision. Complications tend to be higher with "high volume" centers. A reasonable price would be $3000-4000 for both eyes. Regards, Mireen Castagna/The Lasik Center (800) 841-3717

--Alexandra Christine Chebil, MD, FRCSC
Irvine, California

Answer 2:

Andrew Caster, MD, FACS - LocateADoc.com

LASIK is a complex medical procedure. Discount laser centers, contrary to what they would like you to believe, lower costs in many ways that adversely affect quality. Do you think performing 80 procedures in a day lowers quality? Or hiring less experienced staff, including doctors and laser technicians? Or calibrating the laser less frequently? One discount laser center in our area (Los Angeles) does not dilate the patient's eyes prior to surgery and does not have doctors doing the refractions. In laser eye surgery, just like in most other things, to a large extent, you get what you pay for. Andrew Caster, MD

--Andrew Caster, MD, FACS
Beverly Hills, California