I am a student of the grauating class of 2005 at the Dow Medical college, Karachi , Pakistan.I am thinking of having the Lasik procedure done. I had the corneal topography as well as the wavefront diagnostic procedure[zywave] done. I am -2.5 myopic and my no. has been more or less stable for 2 years. The results that came on corneal topography were...
RIGHT EYE
P.B.F.S- 52.4 D{<55D}
difference-0.033 mm{0.050mm}
K1-44.2 D{48D}
K2-43.3D {39D}
W.T.W-11.6mm
Pupillary diameter 4.3mm
thinnest point-595 um
pachy ratio 1.14 um {<1.16}
Corneal thickness-596 mic.
LEFT EYE
P.B.F.S- 52.6 D
difference 0.035 mm
K1-43.9 D
K2- 43.3 D
W.T.W-11.8 mm
P.diameter- 4.7 mm
thinnest point-590 um {>480um},
Pachy ratio-1.16 um.
Corneal thickness-591 mic.
and on Zywave.....
WAVEFRONT DATA
RIGHT EYE-
MANIFEST REFRACTION
Sphere- 2.50
UNDILATED ZYWAVE REFRACTION(3.5mm PPR)
Sphere. -1.90, Cylinder. -0.24, Axis- 39 degrees, Pupil Diameter- 6.49 mm
DILATED ZYWAVE REFRACTION(3.5mm PPR)
Sphere. -1.82, Cylinder. -0.16, Axis- 45 degrees, Pupil Diameter- 7.27 mm
LEFT EYE
MANIFEST REFRACTION
sphere. -2.50
UNDILATED ZYWAVE REFRACTION
Sphere. -2.09, Cylinder. -0.23, Axis- 100 degrees, Pupil Diameter- 6.90 mm
DILATED ZYWAVE REFRACTION
Sphere. -1.87, Cylinder. -0.35, Axis- 94 degrees, Pupil Diameter- 7.78 mm

The doctor is now saying that my pupil diameter is a relative contraindication to any kind of Laser refractive surgery. I am 24 years old male and i do not have any associated opthalmic or any systemic disease whatsoever.I have read that Pupil size if large can result in problems with night vision but it is not a contraindication esp for a low myope like me with good corneal thickness.I would like some feedback.

Fahad Khan.

so your -2.5 without astigmistim in both eyes but have dilated pupils over 7mm? This does place you at increased risk of decreased night vision. How large an ablation zone can your doctor do? Have you heard about Intacs? This might be another alternative, do a search for Intacs on google. How well can you see uncorrected? With a low refractive error as yours you may not be very dependant on glasses. Im not a doctor by the way.

I can drive without contacts in the daytime but have some problems at night. The problem is that the Wavefront Laser used in my city (in Pakistan)
can only create an optical ablation zone of 6.5mm. Also the doctors here are not very experienced with Lasik esp Custom Lasik as few people here get this procedure done.

News releases on KeraVision, the maker of Intacs, announced company layoffs (on 11/20/00 and 1/16/01) and stock market delisting. On 3/23/01, KeraVision filed bankruptcy. It is not known whether future events will impact product liability and the availability of implants for patients desiring segment exchanges. On 4/22/01, the sale of KeraVision's assets to Addition Technology, Inc was approved.

The info on keravision is old news. Intacs was beaten out by PRK and LASIK so the company keravision was never profitable. But Intacs works nicely for patients with low degrees of myopia with minimal astigmatism.
Of course - Intacs are used now to treat keratoconus and ectasia following LASIK.

I hope this helps

Bill Trattler, MD
Miami, FL