Correcting Laser Eye Surgery Side Effects

Question

I had laser surgery done 4 years ago and still have starbursts, halos, and glare. Is there any help for me?

Cary M. Silverman, MD · Answer

You need to be evaluated to determine if there are any spherical aberations causing your visual complaints. If so, these can usually be corrected with a custom-guided enhancement. Discuss this with your operating surgeon.

Michael K. Tracy, MD · Answer

Most glares and halos appear to be caused by residual astigmatism after laser surgery. Your surgeon can do a careful cycloplegic refraction and if you have significant astigmatism may be able to repair it with further laser treatment. Alphagan-P (Brimonidine) eye-drops have also proven effective in treating glare and halos at night with most patients taking them daily at sunset. Dry eyes can also cause glares and halos. Finally, it is possible that your symptoms are unrelated to your surgery and are caused by an unrelated eye disease such as cataracts. The first step is to have a thorough eye exam and cycloplegic refraction to determine the cause of your symptoms.

Christopher Coad, MD · Answer

Newer technologies are constantly being developed for the rare patients who experienced undesired results.  Consult a well-trained specialist and don&rsquo;t give up hope.  Things get better.

Thomas E. Clinch, MD · Answer

Sometimes LASIK can induce aberrations or errors as it corrects others. Contact your LASIK surgeon and have them scan your eyes to see what's causing your blurriness. Depending on what they find, they may be able to correct what you're experiencing. Various eyedrops can be used to shrink pupil size as well if driving at night is particularly bothersome.

Jon Dishler, MD, FACS · Answer

If your blurry vision is form something related to the previous surgery, it may be possible to do a repeat LASIK or a surface treatment to improve your vision. It is difficult in a short answer to cover all of the possibilities, but you should get an evaluation to find out if this is possible. There is a chance that the problem stems from an internal eye problem unrelated to your LASIK, or your corneas might be too thin to be able to withstand additional surgery. 
Many times though, it is possible to retreat undercorrected eyes. If there was a decentered ablation, then newer treatments coming onboard in the next few years will be able to help. In some cases existing custom treatments can help. We also see patients who have dry eye issues where a relatively simple fix such as punctal plugs can help quite a bit also.

Steven Dell, MD · Answer

There is a good chance that your vision may be correctable. Some of your visual problems may be due to some left over refractive error, or aberrations unique to your eye. The new custom wave front laser technology can often improve this. If your visual problems are due to issues inside your eye such as cataracts, laser surgery will not help. Only your eye doctor will be able to figure this out for you.

Anthony J. Kameen, MD (retired) · Answer

Years ago this complaint was more common than today. In fact, I had PRK performed on my nearsighted eyes in 1994. My vision has remained 20/20 all of these years, however, I do have some minor glare and ghosting that remains. The lasers in 1994 were just not able to eliminate this. I could have this corrected tomorrow with current lasers that no longer induce significant glare, but, actually, reduce it. I have chosen not to do this not out of fear, but due to the fact that the glare simply does'nt bother me that much.

	To answer your question, however, it is highly likely your glare and halos could be lessened or eliminated by a laser touchup. Your next steps would be to go through a thorough eye evaluation by a laser surgeon, who will "map" the surface of your eye(not even available in 1994) and calculate how to improve your situation. I have performed many of these touchups, as I have been performing these procedures for over 15 years.

Gary Kawesch, MD (retired) · Answer

I'm assuming you did NOT have these problems before LASIK.  If eyeglasses fully correct the quality of your night vision, then you have a residual refractive error (ie nearsightedness, farsightedness, and/or astigmatism), and you could consider more treatment with either "traditional" or "wavefront" laser vision correction.  Correction could be LASIK if you have sufficient corneal thickness under your flap, or it could be a surface ablation such as PRK.  Both work well.  Wavefront might be better, but it typically ablates more cornea, and depending on your thickness, may or may not be an option.  It also typically costs more.
If eyeglasses DON'T correct the night side effects, then a traditional retreatment would NOT correct them either.  Wavefront LASIK or PRK would be the only option, and would probably help.  There is a chance it would solve the troubles you are having, but there is also the possibility of only a partial improvement (or rarely, no improvment).  Treating high order optical aberrations such as spherical aberration, coma and trefoil with wavefront guided LASIK is good but not always perfect.
Other nonsurgical options include eyedrops such as Alphagan P at dusk to slightly reduce the size of your pupils, to reduce these night side effects.
And of course, a full eye exam should be done to make sure you don't have anything else going on, such as corneal scarring, epithelial ingrowth, a decentered original ablation, cataracts or even glaucoma, all of which can cause the night effects you describe.

Correcting Laser Eye Surgery Side Effects

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