Hm thanks for this, then Coal Harbour would be a better choice for people with large pupils. It says on their website the optical zone for their laser is 8mm.burnt69 wrote: ↑Sep 2nd, 2018 4:34 amThe FDA labelling for the VISX Star S4 IR laser w/WaveScan abberometry (not to be confused with the newer "iDesign"):
https://www.accessdata.fda.gov/cdrh_doc ... 6S025C.pdf
States, at page 10:
"Patients with large mesopic pupil size (>= 6.6mm) should be advised of the potential for negative effects on vision after surgery, such as an increased frequency of glare and halos, and decreased satisfaction at night under conditions with glare, such as night driving".
"The WaveScan [abberometry] sensor measures the higher order abberations only over the diameter of the patient's pupil to a maximum of 7.0mm"
"No higher order abberations can be measured or treated outside the wavefront measurement region. If the surgeon extends the optical zone beyond the measured wavefront diameter, the nonuniform wavefront transition zone will overlie the attempted sphereocylinderical treatment"
The first reference would infer that the machine would be limited to an OZ of approximately 6.5mm on-label. The third reference implies that a surgeon using the equipment specified can extend the OZ to 7.0mm as a custom off-label treatment, but cannot create a custom treatment beyond 7.0mm.
I personally have monster pupils and light coloured eyes (well over 8mm). Treatment customization limited to 7.0mm at best simply wasn't going to cut it. Nor did it cut it for another large pupil patient, at http://www.isthisyourhomework.com/halos ... prk-lasik/ , who was treated on the VISX at LEC (not PLEC!) in Vancouver and commented accordingly. I cycle and hike at night by moonlight in wooded areas, and I need great night vision -- which I achieved with full treatment customization over my entire pupil.
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