pupil size and night vision

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pupil size and night vision

Postby -RanZ- » Mon Mar 09, 2009 3:42 am

Can anyone tell me what the treatment size is for the newest lasers used for today's lasik? I had my 1 month checkup a couple weeks late at 6 weeks and I mentioned the starburts are still there and my doc said that if it is still a problem after 6 weeks it is likely I will permanently have some night vision issues. He also mentioned that I do have larger pupils. I am going to call my surgen that did the lasik surgery and find out what my dilated size was.
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Postby LasikExpert » Tue Jun 30, 2009 11:14 pm

Six weeks is still early enough that resolution of Lasik starbursts may occur. Furthermore, large pupils do not always mean starbursts or other night vision problems. Read about Lasik and big pupils.

In wavefront-guided mode US approved lasers can treat no more than 6.5mm, less if astigmatism is present.
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Postby -RanZ- » Wed Jul 15, 2009 5:09 am

I had wavefront guided lasik 6 months ago, it took about 4-5 months for the night vision to get better. I am still not 100% and have starbursts/halos but they are smaller and I think my brain is starting to ignore them more. I do have larger then normal pupils but not big enough that they didnt do lasik.

edit: I may be able to get an enhancement but I ended up with 20/10 vision the day after surgery and it is still perfect so I am not going to risk the enhancement
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Can you quantify the improvement?

Postby Anyman » Fri Jul 17, 2009 11:31 pm

-RanZ- wrote:I had wavefront guided lasik 6 months ago, it took about 4-5 months for the night vision to get better. I am still not 100% and have starbursts/halos but they are smaller and I think my brain is starting to ignore them more. I do have larger then normal pupils but not big enough that they didnt do lasik.

edit: I may be able to get an enhancement but I ended up with 20/10 vision the day after surgery and it is still perfect so I am not going to risk the enhancement


Can you quantify how much of the starbursts receded? 20%? 50%? More? Less?

I am 2 weeks post op & find them grating. Wish I didn't believe the Dr when they said I should not be bothered by them. If they are still with me in 6 months we're gonna have a little talk...... :x

I read the "informed consent", which is basically a CYA form for the doctor & asked a bazillion questions, pretty much all along the lines of "I do not want starbursts, halos and other stupid side effects-how do we know I should not get them w/ 7mm pupils?" They told me only a few patients had them after 6 months, with those diminishing significantly since using the Allegreto (sp?) wavefront laser. I am starting to wonder if they have totally BS'd me. I'd hate to have to stand in front of their office with a large sign on operation day "Ask me how Lasik ruined my might vision" sign, but I'll do it! I'll be mighty ticked if they knowingly lied...... I'd be surprised to, since this Dr's reputation is quite good. Found no complaints anywhere on him.
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Well now THIS is intereting--and it contradicts the Doctor!

Postby Anyman » Fri Jul 17, 2009 11:32 pm

LasikExpert wrote:Six weeks is still early enough that resolution of Lasik starbursts may occur. Furthermore, large pupils do not always mean starbursts or other night vision problems. Read about Lasik and big pupils.

In wavefront-guided mode US approved lasers can treat no more than 6.5mm, less if astigmatism is present.


I have 7mm pupils. They told me the allegretto (sp??) laser could treat beyond that. Did they lie?
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Postby -RanZ- » Sat Jul 18, 2009 12:20 am

mine went down probably 60%, they are not that noticeable anymore except in extreme darkness. Orange street lights are probably the worst, others are not so noticeable. I noticed if I use systane drops and my eyes are moist the starbursts are even less noticeable. I would be patient, it should get better.
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Re: Well now THIS is intereting--and it contradicts the Doct

Postby LasikExpert » Sat Jul 18, 2009 2:44 am

Anyman wrote:I have 7mm pupils. They told me the allegretto (sp??) laser could treat beyond that. Did they lie?


Most surgeons use the WaveLight lasers with a 6.5 mm optical zone (OZ) for all treatments, myopic and hyperopic, Wavefront-Optimized and Wavefront-Guided. With spherical treatments the blend goes to 7.5 mm, with astigmatism it goes to slightly over 9.25 mm.

The data show that with emmetropic results, pupil size did not correlate with symptoms using the 6.5 mm OZ. The “effective optical zone” with this laser goes all the way out to 6.5 mm. That is not true of any other platform studied (see articles by Holladay, Boxer-Wachler, and more recently by Mrochen comparing to Visx CustomVue, etc.).

See Kezirian GM, Stonecipher KG. Subjective assessment of mesopic visual function after laser in situ keratomileusis. Ophthalmol Clin North Am. 2004 Jun;17(2):211-24, vii. PubMed PMID: 15207563.
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