LASIK Eye Surgery Questions and Answers

Question:

About one year ago I decided to get gas perm contacts. Because I read it is like a retainer and sometimes helps your eyes. I went for many fittings. The last fitting the doctor told me that there may be a bit of discomfort at first that I needed to get use to them. Months pasted, they still we very uncomfotable. I went to see a new doctor and found that the lens that were prescribed were too steep and were very sharp. as a result it caused my right eye to become a little worse. My new doctor found this to be unfortunate and said it may be able to be corrected. My fear is that I may not be a canidate for lasik because of it. Can I still go through lasik after that has happened?

Answer:

The nice thing about the human cornea is that it is very resiliant. Before our patients have their LASIK evaluations we require them to be out of gas permeable contact lenses entirely for three weeks. This is plenty of time for the cornea to resume it's natural shape, so you needn't worry. Measuring the cornea in it's natural state is essential to a good LASIK outcome. A word of caution though; please be sure you are choosing a doctor and clinic that have a long history and good reputation in your community. Many LASIK clinics have gone out of business since the first of the year, many patients who paid for LASIK in advance got neither surgery nor refunds! The people who ran some of these defunct clinics are already opening up in new locations under other names. A Dr. who has demonstrated a firm commitment to his/her community for many years is far more likely to still be there when you need him/her.

Question:

Would you still be a good candidate for lasik sugery if you had dry eye,an early form of macular degeneration I believe ?

Answer:

Macular degeneration is a disease of the aging retina,very rare in young people, and is unrelated to "dry eye". Dry eye has to do with tear production. Many people choose to have LASIK because their eyes become too dry to wear contact lenses comfortably. Your doctor can determine whether you hav clinically dry eyes, which may require special consideration when contemplating LASIK.

Question:

I was recently evaluated for Lasik surgery, and was told that my pupil size is 8.5 mm, whereas the laser is only 6.5 mm. The doctor told me about a larger laser that is supposed to come out soon that can treat my whole pupil instead of just the center, and he recommended that I wait for it. How sure is it that this laser will be coming out soon, and how safe will it be? Will the doctors need retraining on a larger laser? How large will the new laser diameter be? Also, how bad would my night vision be if i did not wait for the new laser? My doctor said that I might be affected more than just halos and starbursts because of how large my pupils are. Would i be able to drive at night without glasses?

Answer 1:

The Autonomous LADARVision laser (which is already available) is able to perform treatments 8.0 by 10.0 mm in size, which is fine for your situation. Andrew Caster, MD

Andrew Caster, MD, FACS
Beverly Hills, CA

Answer 2:

You may wish to first have the measurement performed by a second clinic, to insure accuracy. Pupils so large are uncommon, and we frequently see patients who've been told they have exceedingly large pupils, (or exceptionally thin corneas) only to discover they were measured innacurately. Our Nidek scanning laser has larger than average treatment zone, we've had no night glare problems among our patients.

Question:

Is it true if I have Lasik surgery I will need reading glasses, which I don't need now?

Answer 1:

Yes, it is possible that you may need reading glasses if you are corrected for your distance vision and are over the age of 40. This is because of presbyopia that worsens in everyone as they age. You may want to consider having one eye treated less than the other to have monovision. Have your ophthalmologist discuss this option with you if you are a can

Answer 2:

If you currently take your glasses off to read, wear monovision contact lenses, or bifocals...options that most people over 40 must use...then you will likely need reading glasses after LASIK, which provides vision similar to that of your distance glasses or contacts. The lens inside the eye loses the ability to change focus as we grow older. This condition is called presbyopia, a Latin term that literally means "old eyes". It is a normal condition that happens to us all, and we expect to have a surgical treatment for it in the not too distant future.

Question:

What is the range of thickness a cornea must fall between in order for an eye to qualify for Lasik as opposed to PRK? (I recently had my eyes examined to see if I qualified for Lasik but was told my cornea was to thin and I would therefore have to have PRK).

Answer:

The rule that is followed by almost everyone is to leave 250 microns untouched. Since, with current technology, the thinnest flaps are 160, that would mean a thickness of 410 microns plus the amount removed by the laser, which varies with your pupil size and degree of myopia/astigmatism. Andrew Caster, MD

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

How can Lasik surgery technique be justified as a medical necissity and not be just cosmetic?

Answer:

Each insurance company has its own policy regarding LASIK. Most avod the question of medical necessity by simply saying that LASIK treatment is excluded from coverage. Andrew Caster, MD

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

What are the major complications of lasik surgery? I have been wearing glasses since the sixth grade I am now 31. I have a slight stigmatism in my right eye. My sight has gotten a little worst since the last time i had them check.I know it's time to check them again. I was considering surgery. I'm just terrified of anyone messing with my sight. But on the other hand i hate not being able to see. Is this an option for me? kathy

Answer 1:

There are many possible complications that can occur, aalthough the incidence is low. Some can be sight threaatening and you need to that carefully with your ophthalmologist about all these possibilities before considering surgery. If your prescription is not stable, you may want to wait until it is more stable. Also depending on your correction, you may not be a candidate. See a good laser vision correction surgeon in your areaa (or several) before making your fin

Answer 2:

final decision.

Question:

My husband who is 57, had lasik surgery for hyperopia in both eyes in 1/01. He is astigmatic with a cataract. His vision is now 20/25 in one eye but the other eye has blurred and double vision. He has been back to the surgeon several times complaining about his vision. He was diagnosed with "dry eye", they plugged one tear duct and gave him drops. This has not helped and he is having a hard time functioning. We would like to get a second opinion. We live in Las Vegas, NV and would be willing to travel out of state. I know California has some excellent doctors and of course the Jules Stein Institue. Thankfully, cost is not an issue for us. We would just like to get the best possible care available. Can you make any recommendations?

Answer:

There are many good ophthalmologists that can evaluate this problem for your husband. I woulld suggest getting a second opinion from a corneal specialist that does not have a relationship with your surgeon if you believe that there may be any bias in the opinion. Jules Stein is a good place to look for an expert as you suggest. Daavid Caaa

Question:

My husband had lasik on both eyes. As of now he has very little vision,the cornia was damaged and is no longer round.What can be done to correct this problem?

Answer:

Most surgeons wait three months or more. Then they attempt to create better flaps and proceed with the surgery. This should be discussed personally with your surgeon.

Byron Stratas, M.D., F.A.C.S.
Wilmington, NC

Next Step

• Learn about LASIK Eye Surgery in the Articles Section
• Ready for a consultation? See qualified Ophthalmology doctors in your area

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