Q: I had a CustomCornea Lasik procedure last Monday (Nov.1) with a very reputable opthalmologist. The procedure went well, and she stated the next morning at post-op that my flaps looked good. But I was still blurry, with some hazing, ghosting, haloing, and light sensitivity. She thought I might have dry eye, and gave me drops with which I have been treating my eyes. To date, the blurriness has persisted, both up close and far away. I still have some haloing, but not as bad, the light sensitivity is gone, and most of the ghosting. There is still some haze. I am a 56 year old female with alot of myopia and astigmatism and an apparently "weird" prescription. I wore hard contacts for 40 years (yipes!) The doctor had me wait over 3 months, without contacts, before she received very close prescription results in the 2 final exams, a month apart. I won't see her for two more weeks, and I realize I can call her office, but I can't wait! I understood up front the complications and the possible need for a second surgery at some point (how long would I have to wait?) I'm fearful that this is the best my vision is going to be. I saw very well with my contacts, but they always made my eyes red and I could never close my eyes for very long. So I opted for the Custom procedure, and was labeled a good candidate. Is it possible I am still healing and the vision will become clearer and better, or are most people usually alot clearer right after surgery? It is very frustrating, as I cannot see well enough to drive. My job requires lots of close paper and computer work all day long. I immediately started working the day after surgery, and I am really struggling, altho my old simple reading glasses help a little. Was that a mistake on my part to start working again so soon? Any feedback from you would be so appreciated - I'm really concerned and am worrying too much! Thank you for your time. Sincerely, Barbara Fuller A: I would hope that your doctor, who is reputable, would have clearly informed you that there is a healing period, more so with Custom Cornea. Your healing doesn't seem very unusual. You should get better over time. Of course, you may need a touch-up, which should not be done usually before 3 months. Andrew Caster, MD

Q: I'm 28 and am thinking of having PKK to correct my vision. Is there a concern for patients who have the PRK procedure and want to have children in the future. I heard that during pregnency your hormones change the can cause your vision to change. Is A: Pregnancy can change your prescription, but only in unusual cases. I would not wait. Andrew Caster, MD

Q: how do you treat epithelial ingrowth and what causes it? A: The epithelial ingrowth must be removed, which is accomplished by lifting the flap and wiping it out. We do not know the cause. Andrew Caster, MD

Q: hello dear doctor, i'm 28 years old guy and i live in iran.i'm sorry to say that i'm iranian,maybe you think that wow iranian?but you can trust on me! i wanna know can i do lasik surgery at my age?i have nearsightness,i mean i can see everything in near but can't see far.will happen any problem or side-effects for my eyes in future if i do lasik surgery?what's difference between lasik and lasek surgery?which method is the best for my eyes.which clinic or doctor do you know in iran to do that for me? thanks alot and best regards A: You probably can have Lasik. You must find a good doctor. Andrew Caster, MD

Q: Hi, I'm just hoping to get another opinion on a concern I have. I'm 25 years old and 6 diopters myopic with about 1 diopter astigmatism. I absolutely hate contacts and have scheduled to have intralasik done (I prefer intralasik over lasik since it "supposedly" is less invasive on your cornea cells especially since I'm so myopic). I have it scheduled to have it done in florida at Dr. Filutowski Cataract and Lasik Institute. They are the only place in florida who actually perform intralasik and not only lasik. But my concern is... I have ALWAYS been told that you should not wear your contacts for 2 entire weeks before the full exam and lasik procedure because I know contacts change the shape of your cornea affecting the prescription so they must be removed for a certain amount of time before having the procedure done. But when I spoke to Dr. Filowtowski's staff they all told me that I do not have to remove my contacts for 2 whole weeks and that 3 days is the new rule they follow and that 3 days is perfectly fine. Are they wrong? That can't be right? I wear soft toric contacts and they told me that I only need to have my contacts out for 3 days before the exam and procedure, BUT I was 100 certain that it must be 2 weeks. Who is correct? Now I am very confused. I'm having the full exam on dec.1 and then the intralasik will be done a week after the exam on dec.7 If I stop wearing my contacts 1 week before the full exam will that be okay? Because I'm going to be out of town and can't wear my glasses before then unfortunately and I don't want to reschedule the intralasik because they don't have anything else available for quite some time. Are you sure 1 week is enough without contacts? They told me 3 days is plenty and now I'm a bit confused. So I fiqure if I do the 1 week thing I will be just fine? Thanks for your time and opinion, Ashley A: I believe that 7-10 days is the minimum, but there is no hard and fast rule. Although intralasik doctors claim that it is better, there is a big difference in opinion regarding this. Andrew Caster, MD

Q: I recently had Intralase Allegretto Wave LASIK surgery. I notice that my left eye is crystal clear and my right is at 20-40 5 days post surgery. How long does it normally take before a person knows whether they will need enhancement to bring both eyes nearer to good longterm correction; and is it more difficult to do an enhancement on an Intralase flap? A: It usually takes at least a month. Enhancements can be done easily on intralase flaps. Andrew Caster, MD

Q: I have heard that the results of conventional LASIK as far as needing touchup are better than for custom LASIK. I have heard the statistics that 1 in 10 need touchups with conventional whereas 5 in 10 may need touchup with custom. Please give me the statistics. A:  For my practice, the percentages of touchups are equal for conventional and Lasik. Andrew Caster, MD

Q: I had custome vue (monovision)about 6 weeks ago. The eye for distance does not have the vision I had after the surgery. Night and dim lighting is really hard to see. my near vision is good/clear as long as I have some light. Is this normal? also I was put on vytorin on 11/2/04 and my eyes are dryer.Is that normal? thanks A: Thee is definitely a healing period that takes 3-6 months. However, you may not have obtained the exact required result and may need an enhancement. Andrew Caster, MD

Q: I live in Ireland but I hope you can answer this question. Would it be standard practice for a surgeon to deliberately undercorrect the vision in one eye during Lasik surgery? The reason given was that at age 42 it would help my reading vision going forward. There is a substantial difference between my two eyes as my other eye is perfect. Thank you for your help. Deirdre O'Brien Galway Ireland A: I believe that the patient should be given a choice to have this done and that it should only be done if the patient chooses. Andrew Caster, MD

Q: I had lasik surgery 2 years ago next week. I have had 2 enhancements on my left eye ( I have mono vision and this is my distance eye. Each enhancement has worsened my vision. I have sever halos, poor night vision, 20-60 distance vision and an after image. I have epideral cells under the flap and a wrinkle. My vision in this eye is not clear at any range. At the recommendation of another specialist, my doctor bathed the eye with an alchohol solution to try to kill the epithelium. Now he is recommending a third lasik treatment. I think I am starting to lose the flap and am afraid to have it lifted again. I have .50 micrometers ( I think micrometer is the measuring unit) and he thinks .10 will be all that I will lose leaving me opportunity for other treatments should they be necessary. I am scared to death. Do you know any one who specializes in repair of Lasik-gone-bad? I am not blaming my doctor. I knew there were risks going into this but I don't want to run out of options if there is someone with more expertise in problems with lasik than my doctor A: I would carefully look around and get a second opinion. Andrew Caster, MD