Could someone please tell me what punctual plugs are? I have been reading alot about them in these forums. I am considering lasik and after reading many questions and answers on these bulletin boards, know that I have in no way shape or form prepared enough to have this surgery. I wear contacts of -4.50 and -4.75 because I cannot see far away. I am 4l, and was about ll when I got glasses. I wore hard contact lenses from age l6 to age 25 and then switched to soft lenses. The soft lenses were far more comfortable but I would like to be able to see without glasses/contacts. I am sick of the hassle. What questions should I be asking my doctor. Since I am 41, I am considering monovision. How often is monovision a success?

To see punctal plugs in action - go to the web site: www.odysseymed.com

LASIK is a very effective surgery for patients with your level of myopia. Before considering monovision, however, you should have your contact lenses set up to simulate monovision (so one contact lens will be for distance, the other for near). I have 100% happiness rate for my patients who tried out the monovision contact lenses first and liked how everything was with them.
Obviously with any procedure there are risks, so please make sure that you talk with your doctor regarding the risks of surgery.

Best of luck

Bill Trattler, MD
Miami, FL

Dr. Trattler: I wrote you earlier about my vision. I have now asked for monovision contacts and the doctor gave me -4.50 in the right, dominate eye, and -3.75 in the left eye to try. He said this would be a +l bifocal. I haven't put these in yet, but if I adjust to them, then how long would this prescription for lasik last? I am 41 and at this time don't need reading glasses. My eyeglass prescription is -5.25 spherein right eye and -5.00sphere in left eye. I am wondering when I would need reading glasses if I went with monovision lasik surgery. Also, the doctor has an autonomous laser. Would this laser be accurate to work with my eyes or would the Visx be better? (I could have the Visx at a different clinic)? I want to narrow the chances of having poor night vision, and halos and those negative side affects.

The contact lens presciption you will be trying, according to your numbers, will be just a slight monovision. As for how long this set up will allow you to avoid contact lenses - the answer is - it is variable. For example, if you end up slightly over-corrected in your "near eye", then you may be able to read comfortably for a few years. However, if you end up on the money, then it may last for 5-10 years. If you end up slightly under-corrected, then it might last for decades.
I often shoot for similar levels of monovision in my patients, and I can tell you that if they liked monovision in the trial contact lenses prior to LASIK, then they loved the monovision LASIK.
As for laser choices, both the VISX and autonomous provide excellent results, and they are both essentially equivelent.
As for night time problems and side effects, you will need to carefully dicsuss all of the risks of LASIK with your surgeon.

i hope you have found this information helpful

Best of luck

Bill Trattler, MD
Miami, FL

Hi Dr. Trattler: I just got your reply and have to tell you I tried monovision contacts for a week and at night, I couldn't see well enough to drive. Things were fuzzy and I had to take out the contacts and put in my glasses. Also, it is something that the monovision prescription worked fine for me during the day. I had no problems at all during the day when there was light. Do you think I should try a slightly different monovvision contact prescription, possibly, to make my left eye better and my right eye less than the prescription I need? What do you think? Otherwise, I have decided on not going for monovision because of the problems at night.