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netkev@gmail.com - 03 Jan 2005 21:52 GMT

I had an initial consultation for Lasik at Laser Eye Center in Orange
County, Ca. The final diagnosis was that my prescription was
low(unsure) but that my pupil size was high(8mm i think). According to
the doctor, because my pupil size was high, there is a high probability
for night time halos and as a result they reccomended WaveFront Lasik
with a cost of $1600/eye for a total of just about $3300.

I searched and read several FAQ posts where they discuss the halo
effect and it's cause. I understand why a large pupil size can result
in halos after std. lasik.

I'd like to hear anyone's feedback on my situation, the doctor's
office, the price I was quoted for the procedure and whether you think
WaveFront will be able to reduce halos in my situation. Thanks for
your time in advance.

-Kevin

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Dr. Leukoma - 04 Jan 2005 00:50 GMT

> I had an initial consultation for Lasik at Laser Eye Center in Orange
> County, Ca. The final diagnosis was that my prescription was
[quoted text clipped - 13 lines]
>
> -Kevin

The easiest question to address is the price. $3300 is quite in line for
wavefront. The other questions aren't so easy to address. I once had a
patient with very large pupils and a low prescription who drove two days
from Canada to see me because he was so depressed by his loss of low light
vision. IN GENERAL, the higher the prescription, the worse the problem.

Basically, the only way to be reasonably certain of a good outcome IS IF
your ablation zone is at least as large as your night pupil. Transition
zones can help, particularly with lower prescriptions. It also depends on
your personality and your NEED for good night vision.

DrG

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netkev@gmail.com - 04 Jan 2005 23:56 GMT

so correct me if I'm wrong but I think he is saying that if the
correction zone is as large as my night pupil size then i will not have
halo effects during the night.

If so, then my question is, does WaveFront lasik have the benefit of
correcting a larger area or can they do this with any lasik technology?
I'm trying to determine if I can benefit from wavefront lasik over
traditional lasik with regards to halo and other negative night
side-effects.

Reply to this Message

Mike Tyner - 05 Jan 2005 02:56 GMT

> so correct me if I'm wrong but I think he is saying that if the
> correction zone is as large as my night pupil size then i will not have
> halo effects during the night.

I don't think all "halos" arise from the junction between ablated/nonablated
cornea, or even from the ring-shaped scar. Some arise from the cornea
itself, a (usually tiny) loss of resolution that comes with slicing healthy
tissue and produces

> If so, then my question is, does WaveFront lasik have the benefit of
> correcting a larger area or can they do this with any lasik technology?

I don't think there's much difference *if* it's LASIK, but some surgeons
prefer PRK for wavefront, rather than LASIK, because the control is better.

> I'm trying to determine if I can benefit from wavefront lasik over
> traditional lasik with regards to halo and other negative night
> side-effects.

Probably wavefront offers a little better control of the peripheral
ablation, but you're still looking through an ablated cornea. With LASIK,
there's still a ring-shaped scar.

It seems to me if your pupils are big and your topography is smooth and
regular, with minor aberrations, the advantage of wavefront isn't as
important as the decision between LASIK and PRK.

-MT, OD

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Mike Tyner - 05 Jan 2005 03:13 GMT

> I don't think all "halos" arise from the junction between
> ablated/nonablated cornea, or even from the ring-shaped scar. Some arise
> from the cornea itself, a (usually tiny) loss of resolution that comes
> with slicing healthy tissue and produces

and I meant to add "produces minor loss of contrast sensitivity"

-MT

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Dr. Leukoma - 05 Jan 2005 04:07 GMT

> so correct me if I'm wrong but I think he is saying that if the
> correction zone is as large as my night pupil size then i will not have
[quoted text clipped - 5 lines]
> traditional lasik with regards to halo and other negative night
> side-effects.

I would be more comfortable if your correction zone was 1.0 mm greater than
your pupil. But, if that isn't possible, go as large as you can.

Currently, only the wavefront platforms have the capability of
accommodating larger pupil sizes. It would appear that the Allegretto
Wavelight has the capability of the largest optical zone of 8.0 mm, with a
blend zone out to 8.7. The B&L Zyoptix goes up to 7.0 mm, with a blend
zone out to 10.

DrG

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