Q: How long does your newfound vision last after LASIK surgery? If you do not need an enhancement, does your vision last forever? I've been told that it only last about 10 years, and you have to have it done again. A: The results of the Lasik procedure are permanent. However, Lasik will not stop your eyes from any changes which they would have undergone in the future without the Lasik. But once you reach your early 20s, it is unusual to have changes in your distance vision. Andrew Caster, MD

Q:  I am told I have 6.5mm pupils with myopia of -3.75 (cylinder 0.5 diopeter) in my left eye and -4 (cylinder 0.25 diopeter) in my right. Corneal thickness is aprox 552 in my left eye and 538 in my right. I am considering treatment using Intralaze (for corneal flap) and a "Wavefront-optimised" ("Alegretto") lazer. However, having read about "Wavefront-guided" laser supposedly giving better all round results including night time vision and contrast sensitivity I don't know if I should be considering this instead...especially as I have most problems driving at night whilst currently wearing contact lenses. I don't care about the cost so much as my eyesight. Which alternative is likely to be better for my prescription? A: Wavefront-guided and wavefront-optimized give fairly similar results in the average patient. For patients with larger amounts of higher order aberrations, the wavefront-guided is superior. Andrew Caster, MD

Q: Hello - I had a consultation for LASIK with a surgeon yesterday. He said that I am a good candidate and the only "word of caution" is about my flat corneas. He said that there is a chance that I may have problems with night vision. He also recommended traditional vs. custom LASIK. Any advice? Also, do you know any statistics on patients with Flat cornea in terms of night time vision? Thank you in advance. Sue S. A: There has been some concern that flattening the cornea beyond a certain range could result in some decrease in the quality of the vision, particularly at night, but this is not known for sure and is in fact debated. Andrew Caster, MD

Q: Hello doctor! I have a question regarding the eye sight of my father and I would appreciate if you would be able to help me with this. About 6 years back my father was unable to clearly see with both his eyes. He could see black spots and was unable to clearly see the persons standing in front of him. For example if he was looking at the face of a person, he would only see the persons shoulders except the face. We did approach an Ophthalmologist who recommended that we go through a Lasik treatment and it would be cured, but after the Lasik treatment, the eye sight worsened and now his vision has deteriorated and he can only see blurred images. I would like to know if there is a treatment for this? Would appreciate your help or any recommendations. Thanks and have a great day! A: It is necessary to know what the medical diagnosis of his problem is. There are many different conditions with different treatments that could be cause of his problem. Andrew Caster, MD

Q: One doctor said I shouldn't wear my contacts 3 days before going in for them to measure my eyes and do the consultation (PRK - my cornea is too thin for the newer Lasik) - another said I should wear my glasses for 2 weeks and then go in - another said only 24 hours. This has me nervous - what is correct??? I wear disposable soft lenses 24/7 - I throw them away after 2 weeks and put new ones in. A: There is no absolute agreement within our profession as to how long people should stay out of their contacts. For extended wear users, I take the more conservative approach of 10-14 days without the lenses. Andrew Caster, MD

Q: Hello, I would like to know whether there is a possible way to change your eyes color. Is there any? Could someone change the color of their eyes or otherwise reduce/degrade their eye pigment? I look forward to hearing from you as soon as possible. A: There is no safe way to change your eye color at this time. Andrew Caster, MD

Q: I have Keratoconus on both eyes and I really would like to get surgery on my eyes. I want to know if this can be done to me. A: People with keratoconus are recommended not to have laser vision correction, except in extremely unusual situations. Andrew Caster, MD

Q:  I had lasik surgery 1 month ago and at my follow-up appointment, my surgeon said he had deliberately undercorrected my eyes (OD -1.00, OS -.50) so as to delay the need of reading glasses (I'm 40 next month). First of all, he didn't discuss this with me previously, and now he's prescribing driving glasses. I could tell my vision wasn't corrected but thought I just needed more time. Is this a legit philosophy? If I'm going to need reading glasses in the future anyway (I don't now), why didn't he just correct me to 20/20 so I could have good vision for a few more years?? Should I seek enhancement? What would my vision be anyway based on the above (20/40??) Thanks for your time. A: It is common to undercorrect one eye only, which is called monovision. However, I think that this is something that should be discussed with the patient, and the patient should choose it if they want. You do not have to have one or both eyes undercorrected, and can have an enhancement to have the vision optimized for distance. Andrew Caster, MD

Q:  Hello my name is Iacobescu V. and I live in Romania. I'm 23 years old and I suffer from short-sightedness. My test results with a topcon are: for the right eye S- 6.25 C- 5.50 A 25; for the left eye S-16.25 C-5.50 A129. And I have congenital ectopic pupils. This may influence the result of the intervention how much? And if the operation is not possible what is your advice {what you will do in my case}. And my ectopic pupils can be fixed ,how? Please send me an email as soon as posible. A: There are some laser procedures that can be helpful in some cases of ectopic pupil, but there are limits. Your prescription in the left eye is too high for laser vision correction. All procedures, including phakic implants, are limited by the ectopic pupils. Andrew Caster, MD

Q: Dear Dr. Caster, I'm a 28yo man living in Italy. I'm writing to ask a question I hope you'll be so kind to answer soon, as it is really important for me. Let's figure that a man you have never seen before is sitting in front of you in your office. Would you (or an average colleague of yours) be able to state and certify, without any doubts: 1) whether the man had laser surgery or not 2) what kind of surgery he had (LASIK, LASEK, PRK, epiLASIK, bladeless LASIK or others)? I'm asking this because I want to have optical surgery and I would choose LASIK, but this kind of surgery is not allowed where I work. We are checked up once per year and I wish to know whether an average doctor, visiting me four or five months after the surgery, would be able to say with no doubts "you had LASIK", or would he be compelled to ask me "which kind of surgery you had?" to be sure. Obviously the greatest thing would occur if the doctor wouldn't be able to state you had laser surgery at all! Thanks in advance for your reply, that I hope to receive the soonest you can. Dr. Maccaus A:  By performing a corneal topography test, it can usually (but not always) be determined that a person had some form of laser vision correction. Looking at the eye under a microscope, an eye doctor can sometimes (but not always) see the edge of the corneal flap, whether the flap is made with a keratome or the IntraLase laser (it is typically easier to see the edge of the IntraLase flap). In the case of LASEK, PRK, or epiLasik, you can sometimes see the minor haze that often occurs, but of course that haze could be due to other things, so a doctor could not say for certain that these procedures took place. Andrew Caster, MD