Very Large Pupils and Lasik Surgery

most surgeons feel that larger pupils carry the risk of night symptoms after LASIK, but every good study published shows there is no relation

clearly i have many patients who have night symptoms that are eliminated by alphagan, which prevents pupil dilation, so this proves that it is related in these people

the only logical conclusion is that pupil size is not related to night problems in most people, but is in a minority of people, so on a statistical basis there is no relation

modern lasers can go wider, so just make sure your surgeon knows how to go off vanilla and increase the default ablation diameter

i'd really urge you to get LASEK instead of LASIK, because with identical zones, i've found less night glare in LASEK when i switched to that from doing LASIK, simply because you don't have a 2-piece, sandwiched cornea afterwards for the rest of your life, so your night vision is typically a little better after the newer noncutting procedures

Dr Emil Chynn

Park Avenue LASEK

Pupil size can range in every person. A few people can have pupils that dilate bigger than 9 mm, but it is rare.

Everyone has a different pupil size, and yes of course its larger at night.  Basic physics dictates that larger pupils, with our without LASIK, have worse vision than smaller pupils.  the question is whether LASIK makes this worse.  The short answer is you dont know in advance.  Every eye is different; different prescription, different pupil size, different curvature, etc.  what we do know is that with current technology, there is no direct relationship between pupil size and night glare.  The chances of this issue are sporadic, and fortunately rare.  There may be a relationship with the amount of correction performed and pupil size and glare, ie high corrections and large pupils but again, we are not currently seeing more than the isolated patient with worse glare at night.

All patients immediately after LASIK have night glare and halos.  It improves each week for up to six months after surgery at which point the vast majority of patients do not report a problem.   Hope this helps.