LASIK Eye Surgery Questions and Answers

Question:

Iwork as a Firefighter. how a IOL can affect me while Iam performing my duties . and how the Heat can affect the lenses inside my eye.

Answer:

IOL's will be no more affected by your work than your natural lenses would be. IOL's are placed inside the eye where you will not see or feel them. It would require a pretty severe trauma to the eye to affect them. I wonder why you are considering IOL's at all, given your age. Intra-ocular Lens Implants are used for correcting cataracts, which are rare in young people. They are occasionally used to correct extreme prescriptions that are beyond the range of LASIK. The fact that you qualified to be a firefighter tells me that you do not fall into the second catagory. Because IOL's mean loss of close vision, and dependance on reading glasses, we do not recommend them for people under 40 except in the case of cataracts.

Question:

I work as a firefighter how a IOL can affect me. while Iam performing my duties

Answer:

An IOL (intraocular lens implant) is used to resolve cataracts or, in rare cases, to correct vision for someone whose myopia or hyperopia is so extreme as to preclude them from having a LASIK procedure. We have performed over 10,000 IOL procedures for both cataract and refractive corrections. However LASIK can correct nearly any prescription today- up to -16.00 diopters of myopia (nearsightedness), +5.00 diopters of hyperopia(farsightedness), and 5.00 diopters of astigmatism; therefore IOL's for vision correction are seldom used. This procedure involves removing the natural lens of the eye, and replacing it with an artificial lens. If you have a cataract, the alternative is to do nothing...in which case the cataract will certainly worsen until vision is lost. Surgery is pretty much a necessity for cataract patients. Removing the natural lens also removes the ability to change focus from distance to near vision, and the patient would require glasses for all close, and possibly midrange tasks. For this reason we do not recommend implants as refractive devices (to eliminate glasses) on those who are under 40. People who are much over 40 will already suffer loss of close vision that comes naturally with age (presbyopia) and would require reading glasses anyway. LASIK is generally considered the better option for surgical vision correction (in non-cataract patients) when it is possible, as IOL surgery is much more invasive, somewhat more risky, and a great deal more costly. If you have been advised to have lens implants for refractive correction, I strongly urge you to get a second opinion to insure that this is your only option. If you are in Washington, I invite you to come for a free evaluation, we will be happy to clarify what your options are. As far as the effect on your work, the IOL may cause some reflections, especially at night. a few people experience this and find it annoying, most do not notice it. Because the IOL is inside the eye, you will not see or feel it, nor should it affect your ability to do any task with the exception of close work for which you would need reading glasses.

Question:

ARE DIABETICS EXCLUDED FROM LASIK SURGERY

Answer:

If the diabetes is under very good control, and if there is not extensive retinal damamge from the diabetes, then a person with diabetes can have LASIK. Andrew Caster, MD

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

I had lasik surgery a month ago and I am seeing a shadow above objects. My close up vision is okay but its the farther away objects that have this shadow. An example is when a car is coming at me at a quarter of a mile or so it has an additional set of headlights and it looks almost like a police cars light-bar on top. Will this go away in time? I've asked my follow-up doctor and he doesn't seem to know.

Answer:

Most likely, this will go away. However, you should be getting more useable answers from your follow-up doctor. Andrew Caster, MD

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

After my first appointment, I was told everything looks good for the Lasik procedure, but I may not be a canadate for enhancements because my cornias were to thin. Is this a cause for concern for the Lasik procedure in the first place?

Answer 1:

You may want to consider LASEK or PRK instead as an option.

Answer 2:

Since anywhere from 5-35% of patients need enhancements, I would consider holding off on Lasik at this time. Hopefully in the future, there will be treatments for thin corneas that will still allow you to have an enhancement. Andrew Caster, MD www.castervision.com

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

Dear Dr., I had Lasek surgery less than a year ago. I would like to know if Lasek surgery can cause cataracts? I am 55 years old. Any information or direction would be greatly appreciated. Thank you.

Answer:

LASIK, LASEK, and PRK do not cause cataracts. Andrew Caster, MD

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

Has anyone heard of LASEK? I had this procedure done March of this year. I was wearing -7's (contacts) in both my eyes and standard LASIK was not a good option for me. I had very thin corneas. Dr. Yee of Herman Eye Center is performing LASEK on patients with thin corneas and it is virtually painless - at least in my case. He makes a flap out of your epithelium which is a lot safer and painless like I said. Even his patients that are candidates for standard LASIK are choosing to do LASEK because of the low risk of injury to your corneal tisssue. He is currently co-authoring with other doctors over seas about this procedure and to my knowledge is the only doctor in Houston and possibly the US performing this procedure. I am six months out and seeing 20/15. It is wonderful.

Answer 1:

Dear Maria, LASEK (Laser assisted seu-epithelial keratectomy) as it is called has been aroung for several years and has become more popular in the United States recently. It is basically a version of PRK (Photorefractive Keratectomy) which I have been doing since 1994. I have done LASEK on similar cases like yours with great results (In fact, I believe that I am one of the first to do this procedure in the Palm Beaches). It has several advantages over LASIK in that you can treat thinner cornea. The corneal nerve regeneration is quicker. There are NO corneal flap complications that we all hear so much about. On the down side is the fact that you need to be on drops for a longer time, vision stays blurry for about one to two weeks. A bandage contact lense is used and pain is often greater. There is also a higher amount of haze in some patients, but this usually does noty affect vision and often goes away. The procedure basically is like PRK, but you spare the epithelium and remove it as a sheet after cutting it with a shallow trephine ring and 20% alcohol to help loosen this layer. This allows you to do the treatment directly on the cornea and replace the epithelium and place a bandage contact lens for 4 days. Drops are often need for at least a month unlike LASIK which is usually about 4-5 days. The advancement of newer lasers with smoother profiles and scanning lasers with trackers has made this a great and safe option for laser vision correction in many people. In fact some surgeons offer LASEK as the only procedure. I currently offer both procedures, but will do LASEK on a patient with thinner corneas. Thanks for your insight and comments on your successful procedure. David B. Cano,

Answer 2:

It is great to hear your experience. I recommend and perform LASEK on people who are not good candidates for LASIK, such as people with thin corneas. Although the healing period is much longer than LASIK, it is an excellent alternative. Andrew Caster, MD Beverly Hills, CA

Andrew Caster, MD, FACS
Beverly Hills, CA

Question:

Has any one ever gone completely Blind from LASIK surgery? And if so is it correctable?

Answer:

Yes and no.

Question:

I am used to my crisp wonderful vision from gas permeable contact lenses. I have worn contacts for 30 years. Should I wait until some sort of lens implant is available (I'm aware that Intacs went out of business). I know I would be VERY unhappy with dry eyes, inability to see well in low light such as movie theatres, halos from car headlights, dry eyes. Should I just stick with my gas permeable contacts for now - my vision without contacts is not too terribly bad.

Answer 1:

Yes. Dry eyes and LASIK are a bad combination anyway and you will not see as well as you do with the RGP lenses.

Answer 2:

Your vision after LASIK may not be as crisp as with the RGP lenses. So for now, I would keep using them. Andrew Caster, MD castervision.com

Andrew Caster, MD, FACS
Beverly Hills, CA

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