Newer technology, LASIK enhancements, and starbursts

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Newer technology, LASIK enhancements, and starbursts

Postby cfryling » Fri Feb 12, 2010 8:18 pm

I had LASIK surgery in 1999. Ever since, I have had starbursts and halos, especially at night, which if untreated makes nighttime driving difficult and impairs my lifestyle in general. It seems that I naturally have unusually large pupils; even acquaintances have sometimes asked if I'm on drugs or such (which I'm not). So it does appear for me to be a matter of pupil size (at least to a significant extent).

Since ~2001 I have been using Alphagan P, which reduces the starbursts and halos to a more managable level but does not eliminate them (and the effect only lasts for a few hours). (I also tried pilocarpine which made my vision even worse and gave me a terrible headache.)

I have gradually become more myopic as the years since the LASIK have passed and have needed corrective lenses since ~2003. Around 2006 I was referred to a specialized optometrist who, over the course of a year, I worked with to see if contacts with prosthetic pupils would solve my problem. While they helped reduce halos and starbursts, I could only wear the contacts for about a half hour before my vision would become blurry, they significantly reduced my peripheral vision, and they made everything darker which makes nighttime vision more difficult; in short, these were not a viable option for me. (Normal contacts also do not work for me any more due to the flattened contour of my eye from the LASIK surgery; even specialized contacts for post-LASIK patients don't work for me. As a result, I am a slave to my glasses, and those only help with nearsightedness.)

I have seen several ophthalmologists over the years to see if newer technologies (like Wavefront) would make me a candidate for an enhancement with the hope that the larger operating diameter of the machines would work for my eyes. After extensive testing, every ophthalmologist has given me the same answer: My eyes are very healthy and could easily accommodate an enhancement, but current technology is unlikely to provide an enhancement that will mostly or entirely eliminate the starbursts. The last time I got a consultation for this was about a year and a half ago.

My question is, Is my hope/expectation that improved technologies will eventually allow me to get surgery to correct the starbursts (and improve my current myopia) in line with reality? Can I expect that some day soon a machine will exist that can operate on a large enough diameter for my eyes? My current optometrist held out the tempting (but probably uninformed) suggestion that maybe such a machine already exists in Europe (and I'd be on a flight tonight if that were the case). My ophthalmologist (not a LASIK surgeon) likewise suggested that maybe technology has improved enough in the past few years to justify me giving it another shot at a consultation.

Beyond my glasses and Alphagan P, what hope have I for a future remedy? Do I just keep checking back every couple years? I'm guessing that there are those out there who have a broader understanding of the current issues surrounding this topic who might be able to lead me in the right direction here...hopefully someone reading this board.

Thank you for any suggestions you can give!

Cheers...CJ
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Re: Newer technology, LASIK enhancements, and starbursts

Postby LasikExpert » Thu Apr 15, 2010 9:52 pm

Be sure to read our article about Lasik and Large Pupils for more details.

The technology that seems to hold promise for patients like you is topography-guided customized ablation treatments (T-CAT) Lasik enhancement surgery. A comprehensive article about current US clinical trials is available here. If you are ready to hop a plane, you may find the author of this article of interest.
Glenn Hagele
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Lasik Info &
Lasik Doctor Certification

I am not a doctor.
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Re: Newer technology, LASIK enhancements, and starbursts

Postby cfryling » Thu Apr 15, 2010 11:08 pm

Thanks Glenn!

While traveling to Europe is prohibitive for me, I'm very interested in the U.S. clinical trial and have contacted the author of that article to see if he might be able to provide me with any leads. Needless to say T-CAT has my interest piqued.

And that article is by far the best I've come across on the topic over years of my own research. Thank you for the excellent advisement!

Cheers...CJ
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Re: Newer technology, LASIK enhancements, and starbursts

Postby ma098568 » Mon Apr 19, 2010 7:11 am

i hope you can find a good solution. in general, if the starbursts and haloes arent related to uncorrected area, there is no way to fix it. you can mask the problem with hard contacts or the drops, but it seems as though most of these doctors have no clue what even causes it. most of will say its something on the corneal surface thats not plainly visible. that being said, a laser will not fix it. if it could, we wouldnt be having these problems in the first place.
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Re: Newer technology, LASIK enhancements, and starbursts

Postby cfryling » Mon Apr 19, 2010 5:29 pm

Me too! In my case, it seems pretty clear that the starbursts and halos are, in fact, a result of the uncorrected area, as the Alphagan P (which constricts the pupils) helps significantly with the problem. I'm not aware of any hard contacts that would help, and prosthetic-pupil soft lenses don't fit my eyes correctly. Even hybrid lenses like SynergEyes, which would only help with my new myopia, don't fit me. I'm eagerly awaiting newer lasers like T-CAT that operate on a larger radius. Hopefully they will be available in the U.S. soon! CJF
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