I had LASIK done over 1 year ago. Subsequent to surgery I had DLK stage-1 in my right eye.

My vision is mostly very good in both eyes during the day. The vision in my right eye is not quite as good as the left, there is still some slight refractive error though not enough for a prescription.

At night the starburst is bad enough to make we want to avoid driving at night as I find it too distracting. I don't enjoy going out at night for walks etc anymore as it preoccupies me.

I suffer from dry eye somewhat. I would not say severely in comparison to some of the stories that I have read. It has been worse in the past, where I would find it difficult to open my eyes in the morning. Currently it is mild but not unbearable. My eyes are red and sore in the morning, but I can mostly get on with my day and suffer only slight discomfort.

My understanding is that the dry eye is caused by the nerves that service the tear glands being severed during LASIK. After a year, I don’t expect they will grow back any more than they are and I accept I am probably stuck with that.

The starburst I would be much more reluctant to have to come to terms with. I don’t think my surgeon would be keen to do a touch-up, possibly due to the DLK and no doubt also because I do not have significant refractive error. I was considered and ideal candidate as my myopia was -3.5 in both eyes with no astigmatism. I had so called custom wave-front done. This was done at the most reputable London surgery by one of the most eminent surgeons. Not withstanding this I would not return to him as he was at best disingenuous with me, the details of which I will spare you as it is not strictly relevant and I would not wish to defame anybody.

Self evidently I have some permanent aberrations in both eyes as the remodelling phase must me mostly complete. The starburst is give-or-take the same in both eyes, probably marginally worse in the right. When I am driving at night through a well lit street the starburst reduces dramatically or even disappears, and reappears just as suddenly as I enter a darker lighting zone. This leads me to suspect it is related to the ablation zone being insufficient to cover my fully dilated pupil. There was no follow-up wavefront done, but I do not think I suffer from any astigmatism. The starburst is essentially uniform about the circumference.

I have never been given an explanation of why I have the starburst, though my surgeon did hint that he felt it may be because of the DLK. I know there is some slight scarring in my right eye from a check-up I had done with an independent high-street optician, but this is an unsatisfying explanation as I would expect then to have the starburst in one eye only.

It occurs to me that the only satisfactory explanation is that of an insufficiently large ablation zone, which leads one inevitably to question why. I seem to recall that my pupil size was measured after drops being put in my eyes, presumably to dilate the pupils. Is it possible that this was done incorrectly? If so, is there anything I can have done about this or should I not consider further surgery? I have not tried any of the drops like Alphagan.
I am very grateful for this site as it is both a useful resource and comforting to be able to read lay and expert opinion.

You may have night vision problems, but it may not be due to a discrepancy between your pupil size and the ablation zone size. Lasik introduces higher order aberrations by changing the natural shape of your eye that cause night disturbances. To remedy this, try Alphagan P or try a custom-fit RGP contact lens to minimize aberration.

The reason night disturbances are often due to an inadequate ablation zone size is that this small ablation introduces an order of magnitude greater aberration in the eye than a small ablation. So, a large ablation zone is required but not sufficient for good night vision. Even custom treatment can introduce HOAs, and, especially with Lasik, spherical aberration increases somewhat.

I do not know if you could have surface treatment after Lasik w/DLK, and its probably not particularly safe, but it is theoretically possible. A better choice would be to throw on some custom-fit RGP contacts at night and see if that helps. If Alphagan P/RGP lenses do not help, you know it is not higher order aberrations that is your problem.

Don't give up on those dry eyes. Dry eyes are a cycle, so if you can break that cycle, you might be in pretty good shape. Try some additional preservative-free tears or Restasis. Its possible that eliminating residual inflammation/dryness will break the cycle and restore your eyes to a normal state.

I know that nerve regeneration does continue after 1 year, so you may get some additional help from that area, too.