A huge new study reassures patients with large pupils that they can still have LASIK with no increased risk of night vision problems. One of the most concerning issues to patients thinking about having LASIK or PRK laser vision correction eye surgery is the issue of pupil size and night vision. There is still a myth out there, even among some ophthalmologists that I teach, that large pupils lead to night vision problems because the pupil enlarges under dim light to expand beyond the range of the laser zone. This explanation simply is not the case and many patients with large pupils can still enjoy an excellent results after LASIK or PRK — particularly if Customized Wavefront technology is used. This is an issue I have discussed in the medical literature and an issue I have blogged about previously.
Stephen Shallhorn, M.D., who until recently directed the LASIK program for the U.S. Navy’s Top Gun Pilots at the U.S. Naval Medical Center, recently gave an excellent talk on this subject in San Antonio, Texas at the 6th Annual International Military Refractive Surgery Symposium. This conference was presented by the American Society of Cataract and Refractive Surgery (ASCRS), our largest professional society for refractive surgeons. Dr. Shallhorn found no correlation between large pupils and quality of vision or quality of life symptoms 1 month after laser vision correction.
Dr. Shallhorn first gave an extensive overview of all the literature published on the topic of large pupils, night vision problems, and LASIK and found only one study out of 11 that reported a positive correlation between large pupils and night vision problems. Dr. Shallhorn then discussed data from a study he was involved with that looked at 18,000 patients having LASIK for myopia (nearsightedness), which, as he said, was “many times the sum of all the literature” so far. Out of the 18,000 patients having LASIK, 2,592 had a pupil diameter of greater than, or equal to, 8.0 mm, which most ophthalmologists would call a “large pupil.” In fact, in the past, many patients with pupils this size were turned down as not being candidates for surgery. In this very large series, however, Dr. Shallhorn found that these patients with large pupils statistically “were not at greater risk for quality of vision symptoms or quality of life problems at 1 month post-op.”
See Also
People With Large Pupils Can Now Get LASIK
This blog discusses an article from Ophthalmology, the journal of the American Academy of Ophthalmology, regarding night vision and large pupils in LASIK
Are Large Pupils a Factor When Considering LASIK Eye Surgery?
This blog from Duke University Medical School Department of Ophthalmology discusses large pupils and night vision after LASIK
Clinical Trial Criteria at Stanford University for Large Pupil LASIK study
This reviews the clinical trials conducted at Stanford University Medical School Department of Ophthalmology which examined large pupils and night vision after LASIK
Pupil Size Not A Factor in LASIK Outcomes
This site looks at the Stanford University study of large pupils and night vision after LASIK
Effect of Pre-Operative Pupil Size on Quality of Vision After Wavefront-Guided LASIK
This site offers the text of the paper by Annie Chan, M.D. and Ed Manche, M.D. of the Department of Ophthalmology at Stanford University which looked at the effect of large pupils on night vision after Wavefront LASIK
International Military Refractive Surgery Symposium
Site for the American Society of Cataract and Refractive Surgery (ASCRS) presenting the 6th Annual International Military Refractive Surgery Symposium (IMRS)