I know there is risks with this procedure and am aware of them but, I would like to get a second opinion. I went for a pre-op and this is my data. Right Eye -3.75 -1.25 120
Left Eye -3.50 -0.75 90
Cornea Right Eye 564
Cornea Left Eye 548
Pupil Size 8 in one eye 8.75 in the other

The doctor says I have a 5% chance of halos. He has done over 13000 procedures and uses the Visix S4 with the Wavefront.

Should I go ahead with this?

Although your prescription is not terribly high and it is possible
that you will have a good outcome I would not recommend
refractive surgery to anyone with such large pupils. The optical/
full treatment zone for Visx Customvue is only 6.5mm when
treating myopic astigmatism. With pupils larger than 8mm you
are at an increased risk for vision problems (ghost images, star
bursts, loss of contrast sensitivity, halos, etc.) when your pupil
dilates beyond this zone. Patients with large pupils are also
more sensitive to higher order aberrations (HOA's) which often
increase after refractive surgery. Higher order aberrations are
imperfections in your cornea that are too complex to be
corrected with glasses. HOA's can also cause aberrations in your
vision when the pupil dilates. The incidence of night vision
problems for patients with pupils larger than 8mm may be
greater than five percent. This has not been studied. This
percentage must be based on your surgeon's personal
experience.

You may find our article about Lasik and Pupil size to be helpful. Visit http://www.usaeyes.org/lasik/faq/lasik-pupil-size.htm

Glenn Hagele
http://USAEyes.org
Lasik Patient Advocacy & Surgeon Certification

I am not a doctor.

I talked to one of the top surgeons in the Midwest. He has several honors and being doing refractive surgery for 18 years. He was one of the first few surgeons to work with the excimer laser. At one time there were only 9 in the country and he had one of them. He was involved in the preliminary testing of the laser on refractive surgery. He has performed over 20,000 procedures and only 2.8% of patients need a 2nd procedure. So, I'm trusting him when he says that the pupil size is not as a big factor in halos, night problems as once believed. He said that is more on the aberations on the cornea and with the custom wavefront it is helping in reducing it. Lasers now and days can treat up to 7 to 8 mm pupil sizes but, the cornea thickness does come to play because with a wider treatment zone, more tissue being removed. There is always a risk with larger pupils but, it's not as large as people think. Also, with light coming in from the sides of the eye will always be not as clear as the front. I have yet to have a complete exam by his staff and with him to look at the results but, when I do I will get more questions and concerns answered.

The best information will always be from a competent surgeon who has evaluated your eyes and expectations.

Glenn Hagele
http://USAEyes.org

I am not a doctor.

The best information will come from several opinions from
competent surgeon's who have evaluated your eyes and
expectations. This is of course after you have developed a basic
understanding of Opthamology and have carefully weighed the
risks and benefits of this elective procedure. Many reputable
surgeons might be more concerned about your pupil size.

I would also like to mention that Allegretto, Bausch & Lomb, and
Alcon produce lasers that are capable of treating larger areas of the
cornea under FDA guidelines in the U.S. Visx Customvue would be
my last choice given your pupil size and prescription.