Lasik Eyes Surgery - Dr. William Trattler: 3rd Article from 2005 on pupil size and LASIK

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Dr. William Trattler: 3rd Article from 2005 on pupil size and LASIK

wtrattler@earthlink.net

2005-11-27, 6:00 pm

This is a third article by Dr. William Trattler, published in Eye
World, discussing the importance of preoperative measurements of pupil
size prior to refractive surgery.

The link to Dr William Trattler's article from the Septemer 2005
edition is here:
http://www.eyeworld.org/article.php...&query=trattler

I hope it is clear from these 3 articles that Dr. William Trattler has
been studying the issues of night vision and pupil size, and has not
only contributed to these articles, but presented at National Meetings.

These articles help other physicians understand that pupil size is an
important consideration prior to refractive surgery. Without this type
of research, other refractive surgeons may just agree with the current
group of articles that suggest there is no relationship between pupil
size and night vision complaints.

Article:
Can large pupils lead to poor vision after LASIK?

--------------------------------------------------------------------------------
by EyeWorld Staff

One study concludes they might.

A researcher reports that there may be a correlation between large
pupil size and nighttime vision problems for post-op LASIK patients.
In a study of 103 myopic eyes at Miami's Center For Excellence In Eye
Care, William B. trattler, M.D. concluded that patients with large
pupils (7 mm or larger) that underwent LASIK or LASEK had significantly
more starburst phenomenon than patients with small pupils
(6 mm or smaller).
Patients were treated with the VISX S3 laser (AMO, Irvine, Calif.) with
large zones and blend zones.
The average amount of pre-operative myopia was 5.65 D in the small
pupil group versus 5.51 D in the large pupil group.
The dimensions of the starburst were measured with a Larson Glarometer
(Developed and distributed by Bruce Larson, MD, Hinsdale, Ill.), a
device that tests patients' night vision.
Patients with small pupils had a starburst radius of 7.81 mm, compared
to patients with large pupils who had an average starburst radius of
20.97 mm.
"This is not to say that someone with small pupils can't have
starbursts, since there are other causes of starbursts such as
irregular astigmatism and residual refractive error," Dr. trattler
said. "People with large pupils can certainly do well with surgery,
but their risk for night time symptoms are higher."
Dr. trattler's conclusions are based on using a test to measure
starburst phenomena in post-refractive patients, rather than using a
"patient questionnaire method" as has been used in previous
studies.
In a study of 100 patients on pupil size and vision quality published
in the August 2003 issue of Ophthalmology, Steven C. Schallhorn, M.D.,
director of cornea services, U.S. Naval Medical Center, San Diego,
studied symptoms prospectively (before and after surgery) as well as
clinical outcomes and found that patients with large pupils had
significantly more glare, haze, and halo reports at one month and three
months post-op compared with patients with smaller pupils (2.9 large
pupil versus 1.9 medium and 2.0 small pupil).
But the glare, haze, and halo reports declined after three months
post-op, and no correlation between pupil size and these reports was
found six months post-op.
Dr. trattler said that he is currently analyzing patients VISX
CustoumVue treatments to determine whether wavefront-guided ablations
reduce the size of starbursts in large pupil patients. As well, other
centers are now using the Larson Glarometer to examine the starburst
phenomena with other laser platforms.

Editors' note: Dr. Schallhorn and Dr. trattler have no financial
interests related to their comments.

Glenn - USAEyes.org

2005-11-28, 1:00 am

Dr. Trattler,

It saddens me to see that you are being attacked as something less
than the concerned surgeon that you are, and that you find it
necessary to defend yourself against these unjust accusations.

The attacks against you perpetrated by "Eye" are obviously in response
to your decision to request "Eye" to contribute to your bulletin board
at AskLasikDocs in a manner appropriate to that forum, or to not
participate at all. You will not - and should not - allow your
bulletin board to become filled with the kind of twisted
misrepresentations found in this newsgroup.

I'm sure that anyone who reads even a few of the posts published by
"Eye" will quickly understand the limited value this kind of
participation in any forum. I'm sure that all reasonable people will
understand that the accusations made against you by "Eye", no matter
what the aliases used, are unfounded and without any merit whatsoever.

Glenn Hagele
Executive Director
USAEyes.org

"Consider and Choose With Confidence"

Email to glenn dot hagele at usaeyes dot org

http://www.USAEyes.org
http://www.ComplicatedEyes.org

I am not a doctor.