I have mild astigmatism in each eye and I'm slightly far sited in the left eye. [I don't know my prescription.]
My questions are:
1. Is Lasek more appropriate for correcting the astigmatism than Lasik? I've seen three doctors and only my primary eyedoc is recommending Lasek. He says cutting the flap for Lasik can cause the astigmatic shape of the eye to change. The other two eye doctors didn't agree. One claims that Lasek is performed by less skilled doctors. The other thought the post op discomfort of Lasek was unjustifiable (her statement was that she would never preform Lasek on a family member). Note I have average cornea thickness.
Question 2. My doctor says the axis of astigmatic eyes can change with aging. My eyes have nearly vertical axes. 5 degrees in the right and 15 degrees in the left. Typically the axes will shift torward horizontal. He says that the corrected vision from refractive surgery correction done today could change over the next 15 to 20 years. How often does this axis rotation occur and is it significant?

Obviously - every doctor has their own experiences. But I would disagree with the latter doctors on their views on LASEK.
I have personally performed LASEK on extremely close friends and classmates from school over the last 2 years, and they have been very happy. As well, over the last 18 months, the employees who work in our office have chosen LASEK rather than LASIK for their refractive corrections. LASEK and LASIK can end up with the same refractive result, but there is less risk with LASEK since their is no cutting of a flap.
The major downside of LASEK is that it takes 3-4 days for the vision to recover. But most patients will trade the instant gratification of LASIK for a safer procedure. As for pain - modern pain control makes this no longer an issue. Patients are provided with an oral anti-inflammatory medication (Vioxx) which typically controls the discomfort. In addition, in case of breakthrough discomfort, many surgeons provide dilute anesthetic which can safely be used up to once an hour. So pain typically is not a major issue (I have recently helped with an article on the avoidance of pain after LASEK which will be coming out in the next month).
As for the astigmatism issue - the question is how stable are treatments after refractive surgery. If you treat the astigmatism now, will it come back later? The answer is that for most patients who I have seen back at 5 years from surface laser (PRK) and LASIK - they have been stable.
Please understand this is general information. As well, understand that there are risks with both LASIK and LASEK, and you should carefully discuss these risks with your surgeon.

Best of luck

Bill Trattler, MD
Miami, FL

P.S. The doctor who claims that LASEK surgeons are not as good a surgeon as LASIK is 100% incorrect. The surgeons who have stopped LASIK have stopped because of intraoperative and postoperative complications that can occur with LASIK regardless of surgeon skill (ectasia, flap dislocation, DLK, etc). If that surgeon tells you that he has not had a flap dislocation, intraoperative flap complication, DLK, etc - then either that surgeon is lying or has not performed a lot of surgery.

I had my astigmatism and mild far sightedness corrected on Dec 1st in my right eye using the E-Lasek procedure. I've healed well but 8 days after I was 0.75 diopters near sighted. 12 days post op my doc measures 0.5 diopters near sighted.

But when he measures this I still stuggle to read the eye chart.
My doc says I'm very exacting.

He has me using 1% Pred Forte drops four x a day. NOw my eye pressure is up and I'm using drops for that too.

Two weeks post op both my near and far sight are blurred. I'm worried. He doesn't want to see me again until Jan 2nd. I'm to continue with the drops until then.

I'm very glad I only had one eye corrected so far, since I'm getting by with the other.

Don't panic just yet. Although the epithelium has covered the treatment area, old compromised cells are being replaced and remodeling of the epithelium will continue. As the epithelium smooths, your vision should get better.

If you apply a drop of preservative-free eye drops (TheraTears, BionTears, etc.), does your vision suddenly become very clear? This could be an indication of dry eye and/or that the epithelial surface has not yet smoothed.

Glenn Hagele
Council for Refractive Surgery Quality Assurance
http://www.USAeyes.org
http://www.ComplicatedEyes.org

I am not a doctor.