Halos and Starbursts

Research your concerns in this forum or post your questions if you have had Lasik, IntraLasik, PRK, LASEK, Epi-Lasik, RLE, or P-IOL within the past three months.

Postby LasikExpert » Fri May 11, 2007 7:02 pm

There is nothing to indicate the Lasik flap is an issue for night vision problems. There are no studies that indicate night vision problems are any greater with Lasik than with surface ablation techniques. I don't know of any anecdotal information that would indicate Lasik is more likely to cause night vision problems that PRK, LASEK, or Epi-Lasik.

The Lasik flap is between 8.5mm and 9.0mm wide. It would be very rare indeed for someone to have a naturally dilated pupil this large. Even in total darkness and measured with infrared, this is a rare size.
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Postby JPD » Fri May 11, 2007 10:51 pm

LasikExpert wrote:There is nothing to indicate the Lasik flap is an issue for night vision problems. There are no studies that indicate night vision problems are any greater with Lasik than with surface ablation techniques.


Thanks Glenn,

I must have gotten some bad information than. I remember reading somewhere that nightvision complications (all complications from mild to severe) were like 6% for surface ablation, and 13% for Lasik. I don't know where I read that, it was an internet website. Apparently one with bad information.
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Postby LasikExpert » Fri May 11, 2007 11:00 pm

Not necessarily bad information, but probably incomplete or narrow. Many studies show varied rates of complication, but that can most often be traced to the subset of patients, technique, or technology. It is very easy to compare apples to bicycles in medical studies. That is why our Quality Standards Advisory Committee evalutes many FDA, peer-reviewed, and direct patient outcome studies to determine the curent Lasik results.
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Postby dallasjetfan » Tue Jun 05, 2007 4:53 am

Still have starbursts and halos. Just wondering if I should go and see about having an enhancement? I am a little disappointed with this, but overall my vision is great!
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Postby JPD » Tue Jun 05, 2007 3:02 pm

dallasjetfan wrote:Still have starbursts and halos. Just wondering if I should go and see about having an enhancement? I am a little disappointed with this, but overall my vision is great!


I would say no, for four reasons. You're surgery was April 5th, correct?

1. Two months is too soon for an enhancement.

2. Enhancements typically won't fix night visions problems.

3. You're still well within the period where these problems can go away on there own. It can take a full 6 months, and in rare cases longer.

4. The fact that your overall vision is great means with an enhancement you run the risk of an over corrections.


What I would recommend you do is to get a second opinion from a Corneal specialist. They will be able to give a more informed prognoses and opinion on what you should do. They will let you know if your current doctor is handiling the treatment properly, and will be able to make suggestions on other things you could do, if you're not already doing it. And since they aren't the one who performed your surgery, and have no risk of liability based on the surgery outcome, I think they will be more open to giving you the real scoup on what your chances are of having this problem permanently. I'm not convinced that the doctor who performs your surgery is always on the up and up with explinations they give regarding complications.
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Postby peakaboo » Wed Jun 06, 2007 2:49 am

LasikExpert wrote:The Lasik flap is between 8.5mm and 9.0mm wide. It would be very rare indeed for someone to have a naturally dilated pupil this large. Even in total darkness and measured with infrared, this is a rare size.


My scotopic pupils,according to the customvue surgical treatment plan report, were 8.8 and 8.3 in diameter. Flap was 9.5 dia. Not surprisingly, I have night glare and halos.
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Postby JPD » Wed Jun 06, 2007 3:24 am

peakaboo wrote:My scotopic pupils,according to the customvue surgical treatment plan report, were 8.8 and 8.3 in diameter. Flap was 9.5 dia. Not surprisingly, I have night glare and halos.


That makes no sense. Your flap is quite a bit larger then your dialated pupil, so why would it be "not surprising" that you have glare and halos?
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Postby LasikExpert » Wed Jun 06, 2007 3:11 pm

The Visx S4 CustomVue wavefront-guided excimer laser has an optical ablation zone of about 6.0mm, which becomes smaller if astigmatism is corrected. User peakaboo has naturally dilated pupils that are reportedly about 8.8mm wide. This means that the 2.8mm ring from the fully corrected optical ablation zone to the size of her pupils is undercorrected.

The Lasik night vision problems are undoubtedly not caused by light striking the edge of the Lasik flap. The Lasik night vision problems are caused by a ring of myopia (nearsighted, shortsighted) at the outer edge of the cornea that mixes with light passing through the fully corrected center of the cornea when the pupils expand.
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Postby JPD » Wed Jun 06, 2007 7:50 pm

LasikExpert wrote:The Visx S4 CustomVue wavefront-guided excimer laser has an optical ablation zone of about 6.0mm


I did know that.

LasikExpert wrote:which becomes smaller if astigmatism is corrected.


That I did not know.

LasikExpert wrote:User peakaboo has naturally dilated pupils that are reportedly about 8.8mm wide. This means that the 2.8mm ring from the fully corrected optical ablation zone to the size of her pupils is undercorrected.


I concur

LasikExpert wrote:The Lasik night vision problems are undoubtedly not caused by light striking the edge of the Lasik flap.


That's exactly the point I was trying to make, which is why I said her statement made no sense.

LasikExpert wrote:The Lasik night vision problems are caused by a ring of myopia (nearsighted, shortsighted) at the outer edge of the cornea that mixes with light passing through the fully corrected center of the cornea when the pupils expand.


That's my opinion also. It looks like you and I agree on this matter.
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