Q: I was recently declined as a candidate for LASIK; the surgeon admitted he was conservative, but did not feel comfortable doing the procedure due to my larger than normal pupil size (7mm), high degree of both nearsightedness and astigmatism, and steeply curved corneas. He said there might be another surgeon who was more aggressive and/or familiar with different technologies who would be willing to do the surgery. Are there technologies that would minimize risks associated with my issues? Is it worth it to take the risk, if it would help minimize my dependence on contact lenses? A: Go get another opinion. It depends on the exact measurements. Andrew Caster, MD

Q: Dear Dr., Would you please tell me what are the cons and pros of intralase and convential way to cut the flap? Thanks. Regards Lee A: There is a great deal of disagreement over this. I actually prefer the conventional way, but the makers and users of the intralase promote it as better. If there is a difference in favor of either one, it is very minor indeed. Andrew Caster, MD

Q: I had lasik surgery (monovision) 1-13-05. I have not been able to see clearly since. In fact, my vision is worse now than prior to the surgery. My distance vision and close vision is blurred and ghosty, and night vision is very "halo'd." My surgeon has put me on FML drops 4x a day; and Systane as needed. He has given me a prescription for reading glasses and distance glasses, and indicates that he feels at the end of 6 months, my brain should be in "sync" and I will see clearly. My eyes are very dry to the point that when I wake in the a.m., I cannot open them all the way--no discharge, just "squinty" until I can get my drops in. My doctor is aware of all these problems, but just says to wait it out, and if not better in 6 months, he will do another surgery putting both eyes to distance and I'll have to wear glasses again for close work--back where I started from. It is becoming very frustrating since I work with documents all day! Should I seek another opinion or does this sound common? A: It is common, but i would also get another opinion. You might try Refresh PM eye ointment at nighttime to help with the dryness while you are sleeping. It is thicker than the other drops. Andrew Caster, MD

Q: hi- I had lasik in 1997, and achieved 20/15 vision for approximately 3 years, then regressed to 20/50 (R) and 20/60(L) over the last few years. I had an eye exam recently and was told i was a good candidate for 'enhancement', and would like information on which procedures would most likely be used. Thank you Danielle McCabe, PhD A: Usually, Lasik is used. Andrew Caster, MD

Q: I am now 50 days after lasik. I was a high myopic. -7.50 was my soft contact lense prescription. I am overcorrected after lasik (using +0.75 reading glasses at the moment.) and have problems seeing in dim light. What are my chances of NOT needing enhancement? On day 2 I had double vision and the doctor reduced my steroid drops to 3X per day to be used for 1 month. A: Thre is still a chance, but most likely you will need a small enhancement. Andrew Caster, MD

Q: I was told that I qualify for Intralase and that my astigmatisms could be causing my migraines... Is this possible? A: Astigmatism is not caused by migraines. Andrew Caster, MD

Q: I recently had Intralase, Wave Front Custom View lasik. During the procedure, the Intralase on my eye lost suction. My doctor reset the Intralase and finished cutting the flap. Three weeks post-op, I still have hazy vision in my left eye. I have been told I have flap edema. Do you have any thoughts? Should the Intralase been suspended and tried at a later date? Does flap edema ever resolve? thanks. A: Usually, the doctor resets the IntraLase if suction is lost. Flap edema will resolve over time. Andrew Caster, MD

Q: What is the price for an operation with lasik for 2 eyes thank you A: It varies, from around $1000-$6500. There are many factors that affect the price, but to a great degree you will get what you pay for. Andrew Caster, MD

Q: I wear colored contacts to correct my vision and astigmatism. I would like to continue to wear colored contacts with no vision correction after having LASIK (or similar) surgery. Is it possible, is it healthy for your eye considering the "flap" that remains? A: It is fine to wear contacts after Lasik. Andrew Caster, MD

Q: Hi, my biggest concern about Lasik is reduced night vision. I feel like I could deal with it on a temporary basis though. Do you have a rough estimate of the percentage of patients that experience night vision problems (halos, glare) at one month, two months, three months, etc post-op? Thank you for your help. -Tim A: It really depends on your degree of correction, and maybe on other factors such as pupil size. Overall, the percentage with today's lasers is very low after 3 months, but at least 30 during the first 3 months. Andrew Caster, MD