I have seen some answers to this issue on the board but would still like to pose it to the Drs. participating in the forum.

I visited my Dr. here in Libertyville, IL for a preop exam. She measured my pupils with a ruler/scale @ 7mm. My myopia is at -7.75 and no astigmatism in the left eye and -7.25 and -1.0 to -1.25 @ 100 in the right eye. I don't know what my corneal thickness is but was told that they were adequate for the procedure.

My concern has to do with night vision. Currently when I wear glasses I have no halos, streaming, starburst, etc. When I wear contacts, I get some halos but no appreciable streaming of light.

I am an engineer by occupation, I am an avid handball player, I enjoy driving, photography and flying radio controlled airplanes.

My question is that given the size of my pupils and that the area of the cornea to be treated being 6.5mm, how likely is it that I will have long term issues with night vision anomalies?

My surgery while scheduled for this coming Wednesday, 3/8 could be canceled and rescheduled should I choose to do so.

I am considering LASIK because I am not satisfied with the visual acuity that I can attain using contacts. Glasses are an option but present other issues that I would rather not deal with. I have been wearing corrective lenses since the age of 8 or 9.

Any comment from you would be greatly appreciated.

Thanks

If your pupils are 7mm or greater you have more
risk of low light glare/halo problems unless a
laser capable of larger optical zones is used. If
your Rx were not so high this would not be a
problem. Please clear this up with your surgeon
before you proceed.
Leonard FriedmanMD Washington DC......

Eric:

I live in Lindenhurst, IL. Could you please get in touch with me via e-mail (). I would be interested in knowing your experiences with doctors in the area.

KAD

I apologize if this posting is too late, but Dr. Friedman's advice is right on target. Make sure your surgeon uses a laser that can treat larger optical zones. I would be happy to see you in my Highland Park office where I have access to a Bausch & Lomb Technolas Laser.

Parag A. Majmudar, MD

By the way, Eric, I may know who your surgeon in Libertyville is...If it's who I think it is, she asked my advice last Saturday about a patient who had similar parameters to yours and I gave her the same advice I gave you...I would use the Technolas or similar laser.

Dr Majmudar -

My right pupil is 25% larger, thus a ghost image in the right eye after lasik on 2-16-00. 20/20 in both eyes now and very satisfied with the results except for the 2nd image. Would you recommend an enhancement to correct a larger area in the right eye, and if so, could you do the surgery? My Dr. recommended 1/2% pilo to shrink the pupil but my eye felt strange and I was afraid of retinal problems and discontinued it. My Dr. did not want to try an enhancement for fear of messing up the 20/20 vision - also his laser may not be capable of the larger area correction. My e-mail address is if you wanted to send a direct message. Thanks ... Troy

Troy
I beleive that wavefront treatments will offer the best method for enlarging optical zones. I do not believe that current lasers can enlarge an optical zone without also affecting the visual acuity, and thus any treatment to enlarge the optical zone may end up causing you to have worse distance vision.
Besdies pilocarpine, you can ask your doctor about alphagan - which keeps the pupil small at night without increasing the risk of retinal problems. Please ask your doctor about this possible treatment

Best of luck

Bill Trattler, MD
Miami, FL