2 years post custom LASIK. Before: -2.25 in both eyes; little to no astigmatism. After: 20/15 in both eyes; no astigmatism. Pupils are rather large (I think maybe 9, not exactly sure). The doctor said it was low risk using custom LASIK. No recollection of these problems before surgery. I noticed the starbursts and halos right away. Waited 6 months, no improvement. Waited 9 months, no improvement. 2 years later, no improvement. The best way to describe it is when driving at night, if I am in the right hand lane of a 4 lane divided highway (with a wide grassy median), and a car is in the far left lane coming at me, the starbursts from his oncoming headlights reach all the way across into my lane. With multiple cars, I don't have a chance. Movie theaters are also a nightmare with halos.

I've been back to this doc now 3 times, and he says there is no reason why I should be having problems. It's like he doesn't believe me. He says the flap looks great, prescription is good, eyes are very healthy. He says it must be dry eyes and sends me away. I've been using drops for 1 year now with no improvement. At this point, I really need some answers and a plan.

I would like to get a second opinion. What is the likelihood that my situation can be improved and what would be the approach? Would wavefront be the solution? Wavefront wasn't widely available when I had my procedure.

You have possibily 9mm pupils. This is probably 3mm larger than the 6mm ablation zone which was common. If your own doctor can or wont help you any further, may be time to see others. Ask for a topography and also discuss if its possible to get your ablation zone enlargened. With your low pre lasik pescription, hopefully you have enough cornea left for wavefront and/or larger ablation zone. How well were you seeing before lasik and now? What about reguarding snellen accuracy?

Wow. It's nice to finally hear a common sense answer! I'm going to contact my doc one last time to see if he will do an enhancement using wavefront to widen the ablation zone. I'm going to request my chart so I can answser your questions more specifically, but I think I was seeing about 20/80 in both eyes before surgery. I don't think they had much to take off, so I could probably do another pass. I'm not sure what "snellen accuracy" is, but I will ask. Thank you so much for the response. This is a great resource.

The Snellen test is the black letters on white background in progressing sizes, often called an eye chart.

You may want to ask your doctor about using pilocarpine or Alphagan P eye drops to reduce the size of your naturally dilated pupils. This may improve night vision.

Wavefront-guided ablation may or may not be the answer. The size of the laregest full correction wavefront-guided ablation is smaller than the size of the conventional ablation. If your problem is due to undercorrection at the periphery of the cornea (and that makes perfect sense), then a conventional laser ablation enhancement surgery may need to be considered.

Glenn Hagele
http://www.USAEyes.org

I am not a doctor.

Glenn,

Thanks for getting me started in the right direction. I think I have renewed confidence in approaching my original doc and asking for an enhancement. Thanks for the great website resource. I'll be pouring over it this weekend.

- Stephen

Keep in touch with us. If you decide to get enhanced, let us know how it went. Also let us know what the doctors say. 20/80 visual accuracy isnt bad for -2.25 diopters, were you corrected to 20/15 with glasses?

I too have contemplanted lasik but I have huge pupils similar in size to yours and also my vision is much poorer at -5 diopters with 20/30 best corrected. I may have poor night vision then, especially with my higher degree of myopia and poorer vision. I dont even know if there is any type of surgury that can be done, maybe aphakic intraoccular lenses but im too young to give up all accomodiation.