Q: Whats the best surgery for a nearsighted 21 yr old college student: lasik or lasek? A:  It depends. Lasik is more commonly chgosen. Andrew Caster, MD

Q: I'm an 18 year old who is interested in PRK. My contact lens prescription is -4.75 in both eyes. Is a procedure a good idea for me, or are there other options? Also, what would be the average cost of such a procedure? A: Lasik is a possibility. Andrew Caster, MD

Q: Dear sir How are you I am writing from Mongolia located in the Central Asia. I wear +5 and +5.5 glasses. I would like to make LASIK vision correction. Please send more details. Price, procedures and ETC. Hope to hear from you soon. With best regards A: We do not do Lasik on such a prescription. Andrew Caster, MD

Q: Hello, i suffer with severe dry eye syndrome and find it difficult to tolerate contact lenses. i participant in contact sports so glasses are not ideal for me. is there any refractive surgery that i could have that will not make this condition worse? many thanks and kind regards. jessica pickford A: PRK does not make the dryness worse. Lasik can make it worse in some cases. Andrew Caster, MD

Q: I live in Bakersfield and have narrowed my search down to 2 doctors. I have a significant astigmastism in both eyes, however I am told I am a "good candidate for LASIX." Which equipment is better for me, LADAR or VIRY II?? Or will the operator truly be dependent on my outcome? Thanks for your input. A: If you are using the newest versions of the LadarVision or the Visx, it does not make much difference. Andrew Caster, MD

Q:  I had wavefront lasik performed on 11/19/04. At my follow up appt. the next day, my vision was approx. 20/30 although I couldn't see any of the lines clearly and was guessing the letters on the smaller lines - 20/40, 20/30. I still am squinting to read traffic and street signs and cannot see as clearly as my neighbor who is 20/20 or my husband who is also corrected to 20/20. I suspect that my actual vision is really closer to 20/40 or 20/50. The surgery was VERY expensive - done at Duke. Is this the best I can expect? I certainly hope not or I will be disappointed. My visual correction was -2.00 in both eyes with a manifest of -2.25 in both eyes and I was also astigmatic - -1.75 in both eyes. What is your opinion on whether I can expect any more improvement? Thanks. Linda G. A: Your eyes should improve over time. If they do not significantly improve, then an enhancement will be performed to improve your vision. Andrew Caster, MD

Q: I have a pretty high level of myopia, which I use lenses and glasses to correct. However, at night I am bothered by double-images of things, especially lights. They're not really halos; more like a mirror image on top of the original...the farther away I am, the greater the separation of images. Is this a corneal aberration, and can any type of Lasik procedure correct it? A: This may be due to astigmatism. You should obtain a consultation. Andrew Caster, MD

Q: Is there a possibility that after Lasik surgery the flap could reopen? A: Yes, trauma can reopen the flap. This is much more likely in the beginning. Andrew Caster, MD

Q:  If I have a Lattice Degeneration whats the best to way to get the LASIk done. A: If this is lattice degeneration of the retina, then see a retinal specialist prior to the lasik. If it is a corneal problem, then lasik may not be advised. Andrew Caster, MD

Q: What is the difference between Custom LASIK and CustomVue Laser Vision Correction? I had Conventional LASIK in 1998. I had myopia and astigmatism. I am experiencing regression, i.e. I am definitely loosing my distant vision and I am also not seeing as clear close up. I saw a surgeon at TLC yesterday and was told that I would benefit from Custom LASIK in which my distant vision will be fixed, but I would need reading glasses for close up. Is this a resonable recommendation? What would my vision be like 10 years from now if I undergo the Custom LASIK procedure? Any comments about TLC Laser Center? Thank you for your time. Dr. Linda Yang, Covina, California A: CustomVue is the Visx brand of custom Lasik. Andrew Caster, MD