Pupils and LASIK Vision Correction-- Does size matter??

By Andrew Holzman on October 06, 2010

 Does size matter?  This is an age old question that has been debated for years.  Well, finally there is an answer and we have it..  NO,  pupil size does not matter very much, if at all,  when looking at final outcomes in LASIK Laser Vision Correction and in PRK vision correction.    For many years, most LASIK surgeons such as I believed that the size of the pupil was directly correlated to the amount and extent of post op Haloes and Glare following LASIK>   these night vision abnormalities were the biggest problem in vision correction in the first part of this decade.  (However,  with the advent of CUSTOM Vision Correction and the usage of both the VISX CUstomVUE and Wavelight Allegretto Laser, post op haloes and glare have become exceedingly rare).    The assumption that larger pupils (greater than 7.0 mm) cause post op glare is flat out wrong.   How do we know this???    We know this because very large clinical studies, many of which were done on Navy pilots following LASIK,  have disproved this assumed correlation.  Thousands of Navy pilots were studied and they found that Pupil size did not correlate to post op glare.  What was found was that patients who had the highest correction (the worst eyes), had a higher glare and haloing rate.  Pupil size did not matter.   We at TLC Tysons corner measure patient's pupils in a variety of ways prior to LASIK>  We use a  Colvard Pupillometer and also use our CustomVue Wasvescan to measure pupils at the preop exam.   An average pupil size is 6mm.   Since we have both CustomVue and Wavelight Allegretto, we are not worried about post op glare.  .   Patients are counseled appropriately - Pupil size is discussed, but not emphasized.  It has no bearing on the outcome- Visual acuity results are identical.  

So Size doesn't matter after all!       

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