Starbursts: Anyone ever seen big ones reduced or go away?

[Anyman]

Here we are at almost 12 weeks and I STILL see the damned starbursts. Even though I was told virtually everyone sees them resolve by 6 months, I am having a hard time believing that this is possible. How can this be if there is NO change in the last several weeks?

I continue to think this was an enormous mistake despite the supposed reputation of my surgeon. He damn well better make sure this doesn't remain an issue.

[nemesis63]

I'm 9 weeks post up and starburst and dry eye still with me. I trying to be positive.

[Anyman]

I think it is time we who are suffering from the lies, half truths, misstatements and more took a much more aggressive stance and actively retaliate against those who did this to us. Passively complaining on internet boards isn't doing much. We need to be far more forceful. Suggestions?

[nemesis63]

I think it is time we who are suffering from the lies, half truths, misstatements and more took a much more aggressive stance and actively retaliate against those who did this to us. Passively complaining on internet boards isn't doing much. We need to be far more forceful. Suggestions?

Sueing is the only option but there is 6 month recovery time before do anything. They use this period for an exuse to keep you away. In my country lawsuits take about 1-2 years :) No hope in here for me so I'd try something more physical than paperwork. This might sound stupid for the non-lasik and flawless lasik patients who reads this. Let me clearly inform you about our current psychology. If these starbursts and dry eye were causing by my left arm i would cut it off and throw away right now.

[Anyman]

I kinda like the biblical concept of "an eye for an eye" :)

There has to be something victims can do to level the playing field and dissuade liars and cheats from operating on the wrong people.......

[nemesis63]

What is the level of your sturbursts? I can see them even at daylight for ex: cars side mirrors when driving, sun reflections on a windows glass etc. Do you see them at daylight too or just night time?

And there is still 0.50 astigmat in my right eye and dry eye on left one. Beside i guess i'm having that contrast issue. For ex : Think a long and wide hallway (so big that two truck can pass at the same time). Sunlight comes from the beginning of it. And i'm at the end of it (at low light). When i try to see someones face that coming from the begining of the hallway (his/her back turned at the sunlight) i can't see his/her face clearly just black (grey claudy).

[Anyman]

I only see them in darkness, so in that regard I am lucky. I only wish I had seen all the lasik horror websites BEFORE I did mine. Just way too risky.

[nemesis63]

I only see them in darkness, so in that regard I am lucky. I only wish I had seen all the lasik horror websites BEFORE I did mine. Just way too risky.

Me too man. I was blind before this. There were a lot of succesfull lasik patient around me (most of them from family) so i didn't make any research. If i knew %2 of lasik side effects i wouldn't do it.

[Anyman]

Looks like I am outta luck. 4 months in and NO change. Testing with a old .5D contact brings a moderate reduction, albeit with a little farsightedness.

This stinks. Time to evaluate & look into other options.

Pupil size DOES matter. I don't care what a few say. It DOES. Accept nothing less.

[LasikExpert]

I wonder if the chance for persistent starburst problems increases the greater your vision correction?

Starbursts tend to indicate a rough corneal surface. This is often attributed to dry eye.

Myopic (nearsighted, shortsighted) correction with Lasik is a process of flattening the center portion of the cornea to change the way light is focused within the eye. Night vision problems are sometimes caused by the cornea becoming too flat because of correction of very high myopia vision or starting with a rather flat cornea. Corneal curvature is always evaluated by a competent surgeon prior to surgery and the amount of flattening induced by Lasik can be determined rather accurately before surgery to determine if there is an elevated risk of vision problems.

[LasikExpert]

Pupil size DOES matter. I don't care what a few say. It DOES.

In some circles there is screeching rhetoric that doctor studies say pupil size does not matter. This is absolutely false. The studies do not say this. I have personally conversed with the doctors who conducted several pupil size studies and these authors of the studies do not say this. What they do say, and what we say in our article about Lasik and pupil size issues is that pupil size is not a reliable predictor of who will and who will not have night vision problems. People with outrageously large pupils have Lasik with smaller ablation zones and do not have night vision problems. Equally, some people with small pupils have Lasik and do have problems.

Legal circles are different. Juries have found fault in surgeons who performed refractive surgery on patients with large pupils. There is no scientific basis to support that decision, but juries are not limited to scientific evidence.

The fact that pupil size is not a reliable predictor of night vision problems is counterintuitive because the reduction of pupil size often reduces halos for most (not all) patients who have night vision problems induced by Lasik. Although the reduction of pupil size is a moderator of night vision effects for those who have halos, that does not mean that pupil size is a predictor of night vision problems. There is a big difference between the predictor and moderator.

You will see in our article on pupil size that we recommend the patient consider all the factors and take the path with highest probability of a good outcome.

[Anyman]

He swore up and down I wouldn't have them, but I do. Alphagan gives me relief, but I have read one dare not use it for longer periods due to a rebound effect or loss of efficacy.

He had better fix it or find a way around it. I do not intend to live the rest of my life so afflicted. I wonder how HE would like it if that happened to him? I'll give him a little more time. Night driving stinks. I alternate between very angry and very disappointed. He said that nobody has them after 4-6 months. Guess what? He is either grossly mistaken or he lied. What am I supposed to do? Can't use alphagan for the next 50 years & contacts give only some relief. What does one do?

I still say that pupil size serve as a predictor. When my pupils are smaller I have no issues. It stands to reason that if one's operated zone is smaller than the pupil then one can see the transition. How often does one hear of smaller pupil people having this disability?

I say stay far, far away from this procedure if one has even slightly larger pupils. Not worth the risk.

[Anyman]

I wonder if the chance for persistent starburst problems increases the greater your vision correction?

Starbursts tend to indicate a rough corneal surface. This is often attributed to dry eye.

Myopic (nearsighted, shortsighted) correction with Lasik is a process of flattening the center portion of the cornea to change the way light is focused within the eye. Night vision problems are sometimes caused by the cornea becoming too flat because of correction of very high myopia vision or starting with a rather flat cornea. Corneal curvature is always evaluated by a competent surgeon prior to surgery and the amount of flattening induced by Lasik can be determined rather accurately before surgery to determine if there is an elevated risk of vision problems.

I have these issues even with lubed eyes. The surgeon was "supposedly" one of the better ones. All i know is that he & his office said one thing, yet I have precisely what I told them I was most afraid of. Am I to just let this go and live with it? I think not. I am open to cures/fixes, but my patience is not endless.

[LasikExpert]

Alphagan gives me relief, but I have read one dare not use it for longer periods due to a rebound effect or loss of efficacy.

The first peer-reviewed paper on pupil size reduction for night vision issues with Alphagan was written by Jay McDonald, MD (a surgeon certified by our organization) in early 2003. The use of Alphagan for pupil size issues was initiated in the general ophthalmic population during the several months prior to publication of this first study in the Journal of Cataract and Refractive Surgery. Follow-up studies have been performed by other doctors from Tel Aviv, Germany, Brasil, and Korea, being published in 2004, 2005, 2007, and 2008 . None of these studies report a rebound effect or loss of efficacy. It appears the information you have read is anecdotal and is not supported with scientific evidence, but I'd be interested in any peer-reviewed study that has this finding.

Alphagan P is commonly prescribed as a glaucoma control medication. The most common dosage is one drop in the eye three times a day. Alphagan P for pupil size issues is commonly used only as needed and would conceivably be once each day in the evening as its pupil constricting effects tend to last for about six hours. Alphagan P can be used by glaucoma patients in significantly larger doses than used for halo effects for the life of the patient. I find no adverse effects that realate exclusively to long-term use (medication interatction, allergey, etc. notwithstanding).

He said that nobody has them after 4-6 months. Guess what? He is either grossly mistaken or he lied.

At best, the statement is incomplete. People who do not use effective treatment for halos will continue to have them; treatment including corrective lenses (glasses or contacts), enhancement surgery to resolve residual refractive error, Alphagan P for scotopic pupil size reduction, or pilocarpine for aggressive pupil size reduction.

Can't use alphagan for the next 50 years & contacts give only some relief.

Actually, it appears that you can use Alphagan for the next 50 years. That may not be desired and it certainly was not the goal of your Lasik, but it appears to be a viable response to the halo problem you experience.

I still say that pupil size serve as a predictor. When my pupils are smaller I have no issues. It stands to reason that if one's operated zone is smaller than the pupil then one can see the transition.

Your reasoning may be intuitive, but multiple studies at multiple locations throughout the world have shown that it is wrong. Pupil size is a moderator of halos for patients who have the effect, but pupil size is not a reliable predictor of who will or who will not have halos.

How often does one hear of smaller pupil people having this disability?

Not often, but the occurrence has been well documented.

I say stay far, far away from this procedure if one has even slightly larger pupils. Not worth the risk.

I have warned many people that they may have an elevated risk of night vision disturbances like halos due to large pupils, high refractive correction, high astigmatism, small ablation zone, flat corneas, etc., but whether or not it is an acceptable risk is going to be the decision of the patient. The best we can do is make the patient aware of the potential problem. Discussing your situation in this forum goes to that end.

[Anyman]

I have warned many people that they may have an elevated risk of night vision disturbances like halos due to large pupils, high refractive correction, high astigmatism, small ablation zone, flat corneas, etc., but whether or not it is an acceptable risk is going to be the decision of the patient. The best we can do is make the patient aware of the potential problem. Discussing your situation in this forum goes to that end.

Then why did this supposedly reputable surgeon promise me I wouldn't have them & that I did not have any of the aforementioned risks? I specifically and unequivocally asked if I had ANY risk factors such as large pupils, etc as I again specifically & unequivocally stated I did NOT want night vision issues & would pass on the procedure otherwise. If pushed, he'll no doubt hide behind the "informed consent" paperwork, which contrasts & contradicts what he & his staff personally told me. That I find unacceptable. I am exploring other options and repairs, if possible, but shall not let this go. One way or the other there will be a resolution.