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1-week to go...What do I do? Large Pupils..Should I do it?
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 1-week to go...What do I do? Large Pupils..Should I do it?, Rhonda, 7/08/2005
  answer, William B. Trattler, MD Miami, FL 7/09/2005, (#1)
 One more question....., Rhonda, 7/09/2005, (#2)
answer, William B. Trattler, MD Miami, FL 7/09/2005, (#3)
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"1-week to go...What do I do? Large Pupils..Should I do it?"
Posted by Rhonda on 16:40:16 7/08/2005
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I got a LASIK exam and the Dr. recommended a combo
of PRK and Lasik. He wants to do the PRK in my
dominant eye. He will be using a VISIX 4 laser with
wavefront. I also asked about my pupil size because I
know they can get quite enlarged. He told me they were
8+, but I should have nothing to worry about since my
perscription is (off the contact box) -3.5, -.75 axis 10
and -3.5, -.75 axis 170. Is this a good bet to hedge or
should I go get a second opinion? Right now I don't
really notice glare or bad night vision with my contacts
as long as I'm not tired or have had my contacts in all
day.
What should I do? Should I trust the Dr? Should I get
only one eye done at a time? How big of an area does
the VISIX laser treat?
Thanks!
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1. "answer"
Posted by William B. Trattler, MD on 14:28:52 7/09/2005
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With wavefront guided treatments on the VISX (called Custumvue) your risk for nighttime vision problems related to pupil size would be extremely low. There is a difference in the risk of night time visual aberrations between standard VISX s4 with blend zone vs Customvue - so choosing Customvue would reduce the chance of night time visual aberrations.
I hope this helps
Bill Trattler, MD
Miami, FL
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2. "One more question....."
Posted by Rhonda on 21:47:45 7/09/2005
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Dr. Trattler,
Do you believe my outcome would be better for
eliminating nighttime problems by going with a doctor
using a Bauch and Lomb laser vs, the Star4 with
customview. I've heard the Bauch and Lomb has a
wider treatment zone.
Also, what is your opinion on Lasik vs PRK? Is it worth
the extra healing time and pain for "stronger" corneas?
Thanks!
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3. "answer"
Posted by William B. Trattler, MD on 23:30:12 7/09/2005
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I only have experience with the VISX S4. I have been screening all patients who have had surface ablation (PRK/LASEK/EPi-LASIK) for their degree of night time vision problems after surgery. With Customvue treatment on the VISX laser, patients with your degree of myopia and large pupils did not have a statistically increased amount of night time vision problems compared to patients with small pupils.
So the VISX laser can definitely provide an effective treatment for your degree of myopia.
As for surface ablation vs LASIK - I personally am a fan of surface ablation. Although the healing process is longer, it avoids some of the risks that can occur with LASIK.
I hope this helps
Bill Trattler, MD
Miami, FL
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