LASIK Eye Surgery Questions and Answers

Question:

My lasik surgery took me from -7.00 correction to -.50 in one eye and -1.75 in the other. I am wearing soft lenses to get to full 20/20 vision now (surgery was 9 weeks ago), and am looking forward to "enhancement" surgery at the end of the year. What are the chances I'll be correctable this time to full 20/20 or better? Having worn hard lenses for 30 years, I'm used to seeing "great!"

Answer:

Most rigid contact lens wearers do not see as well after laser vision correction as they saw in there rigid lenses. Some surgeons no keep there patients out of rigid contacts for about 1 month for every ten years of hard contact lens wear before they get the final refraction for laser vision correction surgery. This is because of corneal warpage from the hard contacts. An enhancement is possible so long as your cornea is not to thin and you do not have signs of corneal ectasia.

Question:

I WOULD LIKE TO KNOW ABOUT THE NEW "CK" PROCEDURE FOR EYES.

Answer:

The CK procedure is not FDA approved at this time. It is like LTK in that makes several radially placed "burns" in the cornea that treat nearsightedness. LTK, PRK or LASIK are approved procedures by the FDA for treatment of hyperopia at this time. David Cano

Question:

Dear Dr. Cano, thank you for responding to my question. I did go to a eye Dr. and the thickness of my cornea's was measured at 560. The Dr. said my eyes are healthy and have no keratitis (?)What is that? Also, with my high prescription, would this be higher risk for me to have done than someone with a lower prescription. thank you Laura Smyser lsmyser@lnc.com

Answer:

Dear Laura, Your corneas appear to be thick enough. You may have misunderstood your doctor. He probably said that you have no signs of keratoconus, a condition where your cornea is structurally weaker and therefore bent out of shape. Keratitis is inflammation of the cornea, which is usually time limited. Sometimes keratitis can be secondary to dry eye, which can be a factor in deciding if you should proceed with Lasik. Ask your doctor if you have signs of dry eye. As far as your high prescription, you are at a higher risk of needing an enhancement, or second surgery. If an enhancement is necessary, it is usually performed no sooner than 3-6 months after the initial lasik surgery. During this interim time period, you may or may not need glasses or contact lenses for seeing well depending on how much you underresponded to your initial surgery. An enhancement may not always be possible depending on your remaining corneal thickness. Good luck with your decision. David B. Cano,

Question:

Thanks for your response to my questions. I did want to tell you that I don't need corrective lenses for reading yet. I was told by one doctor that I would probably need reading glasses after LASIK and that monovision could prevent me from needing reading glasses for awhile. Does this make any sense to you? Frankly, I'm not crazy about monovision and I'm tired of people telling me that I'm on the downhill slide toward farsightedness anyway because of my age. I will admit, however, that I don't read as well with contacts on as I would like.

Answer:

Dear Kim, In your case I may suggest that your surgeon may try to slightly under correct both your eyes so that you see fairly well in the distance and retain your reading vision for a while and not have to deal with the monoviosion issue at all as another possible option. Good luck. David B. Cano, M.D. www.canovision.com w. palm beac

Question:

Had a LASIK enhancement done in my left eye two weeks ago and have noticed a consistent floater for the last six days. My Doc did a dilated pupil exam and said everything was ok and I will be fine. Is this "normal" and is there any cause for alarm? Bob E.

Answer:

Dear Bob, Your floater is most likely not related to your LASIK enhancement. Floaters are actually in the media of the eye posteriorly called the vitreous and may occur at anytime. They are a concern especially when they are associated with flashes and more floaters as this may be an indicaation of a retinal problem, so the dilated exam was indicated. Monitor your symptoms and vision and alert your doctor if they worsen. David Cano, M.D. www.canovision.com w.palm

Question:

I had lasik performed last Friday (4 days ago). My vision is flucutating a great deal. Sometimes I see well and other times I can hardly focus on anything. Is this normal? If so, how long will this last before my vision stabilizes?

Answer:

This is normal and to be expected. Be sure to see your surgeon immediately if your vision worsens, have light sensitivity, or any discomfort.

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

Question:

I am a 41 year old female that has worn corrective lenses (both glasses and contacts, but primarily contacts) for nearsightedness since the 10th grade. I have been evaluated for LASIK and have been told that I am a good candidate (vision is -3.5 in my right eye and -4.5 in my left). I have been told that monovision is a good idea to keep from having to wear reading glasses after the surgery. However, I have no idea which eye should be corrected for monovision and which one should be corrected first. I am left-eye dominant and would prefer to only get one eye done at a time.

Answer:

Dear Kim, Traditionally surgeons have picked the dominant eye to be corrected for distance. However, recent publications in our field have shown that there appears to be no patient preference for correcting either your dominant or non-dominant eye for distance. I suggest that you try monovision first with your contact lenses to see if you tolerate it. Wear your full correction in your dominant eye and your reading correction in your non-dominant eye. If you don't tolerate this, than you can try the opposite. If you still don't tolerate this, than monovision is not for you. Hope this helps. David B. Cano, M.D. www.canovision.com

Question:

HOLA: PLEASE I WOULD LIKE TO RECEIVE SOME FEEDBACK. ONE WEEK AGO I SAW A DR. AN EYE SURGEON ON LASIK. HE IS A MEXICAN DOCTOR IN REYNOSA, MX. MY FATHER KNOW THIS DOCTOR FOR OVER 25 YEARS. HE DID SOME TEST AND TOLD ME i'AM A CADIDATE FOR LASIK SURGERY. MY RX R.E -1.00 (SPHERE),-4.OO CYLINDER /103 AXIS LEFT EYE -1.25/ -3.25, 75AXIS ................. CONTACT LESNSE RX -1.00,-3.50 ,100 OS -1.50, -3.00 -.80 ..................... HE DID THE CORNEAL THICKNESS TEST. ON THE OD EYE CENTER 533 MICRO AND THE OS 525 MICRO. THE EXCIMER LASER AVAILABLE IS NIC EC 5000. WELL MY QUESTION IS THIS EQUIPMENT CURRENT OR IS BETTER TO DO IT IN HOUSTON WHERE THE COST 2.5 TIMES MORE? I'M AFRAID TO POST SURGERY EFFECTS LIKE SOME PEOPLE HAS (HALOS,GHOST) Please give some advice, my father trust in this doctor. I'm a 32 years male. gracias

Answer:

Dear Alex, You provided some important information, but not all information that will help me better answer your question. You have a lot of astigmatism. Was corneal topography done? If so, what kind of topographer was used? It is very important to make sure that you don't have a condition called keratoconus, which is a contraindication for lasik. Keratoconus means that the cornea is shaped more like a cone instead of like a ball. It is possible that you have so much astigmatism because of this condition. If you do not have keratoconus, than the next question is, what is your pupil size? When we treat patients with astigmatism, the treatment area can be smaller than when we treat only nearsightedness. With the Nidek laser, usually this can be accounted for by altering the treatment zone. In the US, we can NOT do this with the Nidek laser at this time. In Mexico, your surgeon may be able to change the treatment size, but you will need to ask him yourself. Buena suerte con su decision! David B. Cano, M.D. www.canovision.com

Question:

Hello, I had LASIK performed on my right eye in Nov. 1998, with an enhancement done in June 1999. I posted a question to this website 11/99 regarding the dry eye that followed the surgery, and was advised to try TheraTears four times a day. I tried the TheraTears (in the single use container) several times a day during the day, and found that I got more relief in the morning if I used an eye ointment (Refresh PM or Lacrilube) before bedtime. TheraTears has been highly recommended, but it has not done much to improve the condition of my cornea. At my last checkup (5/01), the cornea still picks up dye and is still missing some cells. I have found that decreasing my intake of caffeine has made a big difference in the dryness, but I still find that the eye is dry. I am also have IDDM, and have improved control of my blood sugar in the past two years. Is there anything else that I can try to combat this chronic dry eye? Since the surgery, I have had regular checkups every 6 months, and I have a punctal plug in both upper and lower lids.

Answer:

Dear Lisa, There are many treatments for dry eyes besides artificial tears and punctal occlusion. It really would not be appropriate to discuss to this in a forum such as this. You require a formal evaluation by a corneal and external disease specialist. Dr. Geoff Tabin is nearby at the Univ. of Vermont in Burlington. You may want to make an appointment to see him for a better evaluation of your specific problem. David Cano, M.D. W. Palm Beach, FL canovi

Question:

I am interested in researching the credentials and practice history of the surgeon I am considering to perform my Lasik Procedure. Please let me know of web sites and other resources available to research his credentials.

Answer:

Dear Pat, The following are good places to look: www.ascrs.org www.isrs.org www.aao.org www.locateadoc.com Also check with your state medical board to see if there are any significant actions against them. Also, see if other people have had surgery and are happy with the results. What better way to find a surgeon than that? David Cano, M.D. W. Paalm Beach, Fl Canovisio

Question:

I AM 41YEARS OLD AND PREPARING FOR LASIX SURGERY. I DEVELOPED KELOIDS ON MY EARS DURING MY TEEN YEARS AFTER PIERCING. SINCE I HAVE REPEIRCED MY EARS AND HAD NO PROBLEMS. I ALSO HAVE A KELOID ON ONE BREAST FROM SURGERY 20 years ago BUT NO scarring ON THE OTHER BREAST after having the same urgery 10 years later. ARE KELOIDS A RISK WITH LASIK?

Answer:

Dear Patricia, More and more report now seem to show that keloids are less important in LASIK surgery than originally thought. They were thought to play a larger role in scar formation in earlier PRK excimer surgery. I think with your decreased formation of keloids in the recent past that you are safer to have the sugery done at this point. David Cano, M.D. W. Palm Bceach, FL canovi

Question:

I had lasik about 3 weeks ago, and the vision in my left eye is not as good as the right eye. I'm told by my Dr. that the eye is dry. but when I use drops in it nothing changes. I also have a lot of halos at night in this eye. I was told that this would not be a problem because they used a star 3 lazer and it was supposed to do a larger area than most lazers. Should I see another Dr. or hold out longer and see if things change.

Answer:

Dear Michael, If your eyes are truly dry, your doctor may want to try and put in punctal plugs to see if this will keep your eyes moist. The Visx S3 and the LADARVision 4000 both have expanded treatment zones. Only the LADARVision Laser actually can do a full correction at the expanded zones, but this is not usually needed and may remove to much tissue in higher corrections. If things are not getting better and you are not getting any answers, then it never hurts to get a second opinion! David Cano, M.D. W. Palm Beach canovision.com Ca

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