I Have Glares and Starbursts After Old Lasik Procedur, Is There a Way to Fix That?

All-laser Lasik is known to diminish the risk of nightime issues. I had a surgery using older methods (blade flap and laser without wavefront) and have glares and starbursts. Is there a way to fix that?

Doctor Answers 5

Glare and starbursts -- how to fix this after LASIK

you may benefit from an enhancement of the procedure, which can be done in a variety of ways--   the two best options in this scenario are typically:  1)you can have PRK on top of the flap or 2) a new LASER driven side cut placed into the old flap and then using that new laser side- cut to lift the old flap.  

It is also possible that medical treatment could improve your sight.  sometimes these symptoms are due to dry eye, in which case appropriate treatment would lessen the symptoms.    there are also medicated eye drops which can reduce the pupil size at dusk/dark, and these can also be used to help you if further surgery is not indicated.   

An evaluation by an experienced surgeon should help determine which option is best for you.. 

McLean Ophthalmologist

Glare and Starbursts from Lasik Performed Long Ago

There is no question that excimer lasers in 2012 are of a higher quality than lasers in 1994(when I had my nearsightedness corrected). It was very common, in those days, to have glare and starbursts as an ongoing side effect, simply because the lasers could not get the cornea as smooth as they can today. So, to answer your question, you can certainly come back in for a laser enchancement that would smooth out your cornea in an attempt to reduce or eliminate your glare. There are a few caveats to this: your cornea needs to be measured in order to make sure you have enough corneal thickness to do this correction, and your eye health would have to be assessed to be sure there is no other reason(like a cataract) for your glare. All in all, though, it sounds like your symptoms could be made better with modern technology.

Anthony J. Kameen, MD
Baltimore Ophthalmologist
5.0 out of 5 stars 1 review

Glare after LASIK

Glare after LASIK is most commonly caused by undercorrection.  Additional causes can be a large amount of higher order aberrations, a treatment zone not centered over the pupil, irregular astigmatism and dryness of the eyes.  The dry eyes are the easiest to fix.  I suggest for starters that you use artificial tear drops at least every few hours and see if this helps.  I have found Custom WaveFront enhancement to help many people.  This is usually performed as a surface ablation.  It is not true that All-laser LASIK decreases glare.  The decrease in glare is found with Custom WaveFront treatment.  People who have femtosecond laser flaps commonly have much more glare after laser than those flaps made with a blade although over time that evens out.

Mark Golden, MD
Chicago Ophthalmologist
5.0 out of 5 stars 3 reviews

Possible solutions to glare and starbusts after LASIK surgery

The first step would be to have an eye exam in a clinic which can perform wavefront measurements as well as a pachymetry measurement (to measure the thickness of the cornea).  An eye doctor can then review the wavefront measurements to determine if the night issues could be resolved by performing a wavefront LASIK treatment over an older procedure.  Many patients have undergone wavefront LASIK to correct either higher order aberrations (such as coma, trefoil, or spherical aberration) or lower order aberrations (such as myopia or astigmatism).  Some doctors have also prescribed eyedrops (such as alphagan) to be used when needed to decrease the pupil size in order to reduce glare and starbursts. There might be a way to help you but you'll need to be examined to know for sure.

Jay Bansal, MD
San Francisco Ophthalmologist
5.0 out of 5 stars 2 reviews

Glare and starburst after LASIK vs LASEK

i have this myself, since i had the same, older, cutting LASIK procedure myself 13 years ago

like you, i had non-wavefront, because wavefront didn't exist back then, and a metal blade

however, it is not true that these symptoms are decreased by wavefront and using a laser to cut a flap, it is decreased by wavefront, the method by which you cut the flap really doesn't matter in terms of night glare, because it's cutting a flap and having a 2-piece cornea that is sandwiched together that contributes to night glare.

when light enters your cornea at night, it hits the flap interface, which never fully heals, and reflects and refracts across this interface, causing night glare

the noncutting LASEK and epiLASEK techniques don't cut a flap, so you don't have a 2-piece sandwiched cornea afterwards, so less night glare

i fix people like you every day at my center. what you need is a PreVue lens to show you how you would see after your WaveFront enhancement. i would do a noncutting LASEK on top of your old LASIK, as this is way safer than cutting a new flap or digging the old one up. your enhancement MUST be wavefront, btw, or it really won't help your symptoms much

hope this helps!

Emil William Chynn, MD, FACS, MBA
New York Ophthalmologist
4.6 out of 5 stars 20 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.