big pupils, small refractive error....night issues

[denverskier]

I am seriously considering laser eye surgery. My main motivation is to eliminate the need for contacts. I typically put in my contacts in the morning and have no problems until I take them out before going to sleep. That said, I don't enjoy wearing contacts while waterwater kayaking or skiing/camping in very cold locations.

My current prescription is -2.00 and -3.50 with 1D of uncorrected astigmatism. Corneal thickness is ~540 in each eye. Higher order aberrations are 0.37 and 0.30. Pupil size is 7mm in a dimly lit room, just over 8mm in the dark.

I have a few concerns. First, PRK vs LASIK. PRK has the longer healing time with dramatic fluctuations in vision. I work at a computer so this would be less than ideal. The intriguing part of PRK is the lack of a flap. A flap complication in the middle of nowhere would be one of my worst nightmares. Everything I read says flap complications are exceedingly rare after the initial healing period and that generally anything causing a flap complication would do similar damage to an uncorrected eye. Another issue of concern is vision at extreme altitude. I have not seen any studies comparing LASIK and PRK at altitudes approaching the summit of Everest.

My primary concern with any surgery would be night vision problems. It is troubling that I have pupils larger than the optical treatment zone of the Eye-Q laser which is what I would be corrected with. Reading about problems with halo/starburst and the depth of people's regret is sobering. It is reassuring that I have a relatively low refractive error and astigmatism. I am also intrigued by studies showing improved night vision and night driving performance after wavefront guided surgery.

I was looking to hear from anyone with similar precorrection numbers about their experience or anyone with thoughts on the matter.

[Anyman]

I am not so sure I would do this...... 8mm is quite large. I have a worse prescription, but 7mm pupils & have nasty night starbursts.

Think looooong and hard before you do this. I was "promised" no starbursts, but that turned out to be less than true. Still working on it, but reserving my other options.

If you cannot live with a worst case scenario, DON'T do it. If you're a gambler, do one eye at a time.....

[denverskier]

After reading every article written about laser eye surgery since 2000, I decided to get LASIK (intralase, eye-q). The procedure was painless. I returned to normal activities the next day but could have easily gone straight back to work had it been urgent. I now see 20-15 in both eyes and have absolutely no problems with dry eye. My night vision is as good as it was presurgery.

[LasikExpert]

Excellent news, and a special thanks for coming back to tell us your experience. Large pupils do not automatically disqualify someone from Lasik and does not always mean poor night vision.

[Anyman]

At least for now.

I wish I were as lucky. I continue my quest to find a solution. One way or the other there will be a resolution. It was not a good thing to see fear & uncertainty in one's doctor's eyes. If he cannot ID the problem someone else may. He should hope so.

For now, I have to spend a fair amount of money to see if there even is a chance of a fix. I'm saving my receipts.

[Bun0]

Hi,

I made the decision to go for eye surgery. I went recently for a free evaluation and considering my condition, the company provided me with 2 options, standard LASIK and Personalised (Zyoptix). I have about -2.00 and -2.50 of myopy and the equivalent of -0.50 of astigmatism. They also noted that I have pupilles a little bigger than standard, although still ok for standard LASIK.

Therefore, they advise for the personalised Zyoptix because I MIGHT get better night vision (less starburst and hase), faster healing and cleaner surgery. They say the LASIK is also very good and I'll probably get very good results too.

Faster healing is not such a big factor for me. Quality/Crisp vision, night vision and risk are more important for me.

The Zyoptix is 3500$ and the standard LASIK 2000$. Eyes are so important, I don't mind paying if it's worth it but I feel like they are trying to sell me something that I don't really need considering my moderate vision condition. So I'd like a an outside opinion before taking a decision. Anyone had this dilema ?

6 months after surgery (after full healing), will the personalized zyoptix be better for me ? Is the extra 1500$ worth my money considering my factors of decision ?

thanks all in advance

[LasikExpert]

What we don't have are hard numbers. What is your naturally dilated pupil size in a low light environment? What is the proposed optical ablation zone (full correction)? Which laser will be used in conventional mode? You can read about pupil size issues and see that there may not be much difference in the final outcome.