Had LASIK 5/99, got a 2nd & 3rd opinion,then had an enhancement 9/99 for hyperoptic astigmatism; have bad ghosting at night since original procedure--makes night driving almost impossible. Doctors all agreed "hyperoptic astig". was the cause of my problem. Now I am 3+ mnths post-enhancement and am being told my ghosting/night problem is due to "slight decentration". This is the first I have ever heard this word and I am scared & confused. Is there no hope for my night vision if my eye is decenterd? What does this all mean? Any hope/help would be appreciated as well as info on decentration.
Thank you.

Decentration can cause your symptoms. Its hard to know without more info about you. Were you near or farsighted before. Ask your doctor about constricting your pupil with drops before you go out and drive. Also,glasses for night driving with a glare coating can help.Finally, decentration can sometimes be fixed with more laser. Sometimes,our present lasers can accomplish this.Visx has a way to apply laser that may have some benefit for you by decentering the ablation. However,Autonomous is working on something called Custom Cornea which hopefully will be availabe soon which will probably be your best bet.
Good Luck,

Gerald Spindel,MD
Derry,NH

Unfortunately, with any hyperopic correction, centration is critical. It makes a much bigger difference than for myopic corrections.

There are projects in the works to address issues like decentration and irregular astigmatism.

If you need the peace of mind of a second opinion, the best refractive surgeon in your area is Dr. Dhaliwal at Eye and Ear. She may not be able to "fix you up" at this time, but at least you'll get the straight story.

Good Luck, Dean Hu