Custom Vue PRK not possible with "small pupils"

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Custom Vue PRK not possible with "small pupils"

Postby kschueleraugsburg » Mon Aug 06, 2007 11:24 pm

Hello!
I am planning to go in for PRK very soon, and not quite sure about wavefront-guided or not-wavefront guided.

Today, I talked to the eye-doctor at the laser center where I wanted to have the procedure done (she is not the surgeon). She said that they would actually need to repeat the wavefront scan. Based on my pupil size (one eye 5mm, other eye 6 to 6.5mm), she said the computer would not allow them to do custom-vue on the eye with the smaller pupil. Does that sound correct? I have never seen any note that said you couldn't do custom (wavefront guided) below a certain pupil size. The laser they are using is a Bausch&Lomb, and they call the custom "Zyoptix".

Any comments?

Thanks!
Best regards,
K
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Postby JPD » Tue Aug 07, 2007 12:26 am

If it's the B&L laser then the wavefront shouldn't have been CustomVue which is for the Visx machine. It probably was the Zyoptix wavefront. Some lasers require the pupils to be dialated to a certain diameter in order to do the ablation. The B&L is probably one of these machines, and the pupil probably needs to be dialated to larger then 5mm, my guess would be 5.5mm or larger.

That is all just an educated guess on my part. Hopefully Glenn will come by and confirm or deny what I said.
Last edited by JPD on Tue Aug 07, 2007 4:01 am, edited 1 time in total.
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Postby LasikExpert » Tue Aug 07, 2007 2:13 am

The concern is not so much the size of the pupil as it is whether or not the data captured is from the normally dilated pupil. If your pupil is normally 6.5mm, but due to ambient light the data is from a 5.0mm pupil, then the system cannot reliably create a proper map to guide the laser. As JPD suggested, some systems require data from certain sized pupils.
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Postby kschueleraugsburg » Tue Aug 07, 2007 1:11 pm

Thanks for the response.
The eye doctor said they would do another wavescan right before the procedure. Would this be the point where they try to create a "map" that would allow the wavefront?

This almost sounds as if people with certain pupil size can't have a wavefront guided ablation, but I never read this anywhere.

By the way, the custom version is Zyoptix in this case.

Best,
K
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Postby LasikExpert » Tue Aug 07, 2007 6:13 pm

The data from the immediate preop wavescan would be used to help map the laser ablation. They want to be sure that they get a reading with your pupil at its largest natural state. That number is different for differnt people, but apparently they think the 5.0mm is too small.
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