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LASIK Problems Reduced With New Laser

Larger Treatment Zone Lowers Risk of Problems in Patients With Large Pupils

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Boxer Wachler uses a LADARVision laser in his Beverly Hills, California, clinic, but his study was not sponsored by its manufacturer and he reports no financial interest in the company. A list of other surgeons trained in using this laser is available at the LADARVision web site.

"This is a good study and an important one, because a lot of surgeons ignore this -- they believe it doesn't matter what the pupil size is," says James J. Salz, MD, a spokesman for the American Academy of Ophthalmology who was not involved in Boxer Wachler's study.

"If you treat a patient with a large pupil with a larger zone, it doesn't guarantee that they're not going to have nighttime complaints," he tells WebMD. "But we think it reduces the chance they will."

Salz, clinical professor of ophthalmology at the University of Southern California Medical School, has this advice for anyone considering LASIK: "Be cognizant of what your pupil size is, and make sure your surgeon measures it -- not just estimates it -- in a dark room. If you have a pupil size greater than 6 millimeters, you are potentially at greater risk of nighttime halos, but that risk can be minimized if they have a larger treatment zone or if they have a customized treatment. I've seen too many patients with large pupils who hadn't and were unhappy with their results."

SOURCES: Ophthalmology, July 2003. Brian S. Boxer Wachler, MD, director, Boxer Wachler Vision Institute, Beverly Hills, Calif.; assistant professor of ophthalmology, Jules Stein Eye Institute/UCLA Medical Center, Los Angeles. James J. Salz, MD, clinical professor of ophthalmology, University of Southern California Medical School; attending ophthalmic surgeon, Cedars-Sinai Medical Center, Los Angeles.

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