Pupil size and LASIK: Dr. Trattler sets Glenn straight
Sandy
"Response"
Posted by Glenn - Sacramento, CA on 16:59:18 1/17/2004
"It is important to note that recent studies have shown that there is
no direct correlation between pupil size and night vision problems.
Some people with pupils larger than the optical ablation zone have
problems, some do not."
Dr. Trattler posted in the same thread:
"There is no question that pupil size is important in refractive
surgery. There are major flaws in the studies that have come out
recently.
1. The Schallhorn study had an insufficient number of large pupil
patients to make any conclusions on the issue of pupil size and night
time vision problems.
2. The Pop and Schallhorn studies have a major flaw in their study.
They looked to see whether patients with pupils that are larger than
the manufacturer's optical zone had night time vision problems. The
problem is that they did not control for the level of myopia. This is
critical, because according to Dr. Jack Holladay's article in JCRS
2002 "Topographic changes in corneal asphericity
and effective optical zone after laser
in situ keratomileusis" - the final functional optical zone for a
patient shrinks with increased levels of myopia. So for every diopter
of myopia of treatment, the final optical zone will be smaller than
the Manufacturer's optical zone.
I am sure this is confusing - but the key is that the articles have
not shown that pupil size is unimportant - and therefore pupil
measurements are important.
I hope this helps
Best regards
Bill Trattler, MD
Miami, FL"
Glenn, not one doctor is willing to post here and publicly agree with
your misguided conclusions. Why is that?
Glenn - USAeyes.org
not.
I am amazed that Keller would be so obvious as to selectively edit a
long and involved thread regarding pupil size, simply to attempt to
create the impression that I am wrong about a subject and/or that
there is some sort of conflict of opinion with Dr. Tratter and me.
Keller's subject line suggests that there is some sort of conflict
between Dr. Trattler's medical opinion and my own, when in fact there
is not. A reader can look at the entire thread at
(http://www.asklasikdocs.com/forum/Pupil/85.html#14) and see that
Keller is clearly and deliberately misinforming the readers of this
forum from the truth and facts of the information provided by Dr.
Trattler and me and how we both agree on this issue, even if we use
different facts to support our conclusions.
What is truly amazing is that Keller would publicly post
misinformation that is so easy to disprove. Keller must believe that
nobody would bother to look at the source of the portended conflict
and see her malfeasance. She cannot possibly believe that I would not
respond with the facts that clearly and substantially prove her
presenting quotes in a manner that can only be construed to be an
attempt to create an outright lie.
My guess is that Keller assumes people only read her subject lines
(which cannot be avoided) and no longer read her posts due to her long
history of misinformation and anti-refractive surgery/surgeon/industry
rhetoric.
If this were not so sad, it would be laughable. Here are just a few
of the facts that show Keller for what she is.
The thread starts with Jim in Ukiah posting that he has 7.5mm
naturally dilated pupils, mild myopia, high astigmatism, thin corneas,
and is considering wavefront-guided PRK with a laser that would create
a 5.0mm x 6.5mm optical ablation zone with a blend zone out to 8.5mm.
Jim has done his research, is suspicious, and is seeking a
confirmation of his suspicions.
In multiple posts, I advise that Jim is not an ideal candidate, refer
him to our article regarding pupil size issues that warns against such
situations (http://www.usaeyes.org/faq/subjects/pupil_size.htm), point
out that his high astigmatism is potentially very problematic, and
advise on more narrow and technical issues. Others, including Rebecca
Petris of www.LaserMyEye.com, advise Jim to be very cautious and
provide additional resources.
Immediately before my statement that Keller quotes wherein I state the
fact that there is no study that provides a direct correlation between
pupil size and night vision problems, I state, "The key is for the
optical ablation zone (full correction) to be equal to or larger than
the size of your naturally dilated pupil. That is the safest route, no
matter what the laser."
Stating the arguments and facts presented by others that do not agree
with my own conclusions is an attempt to provide the reader with a
more balanced and wider range of information, rather than just a
single dogmatic opinion. It is important for a patient to understand
that there are many opinions regarding pupil size and they do not all
agree.
Immediately before Dr. Trattler's statement that Keller quotes as
being counter to my own statement regarding current studies, Dr.
Trattler says "Rebecca (Petris) and Glenn are doing a great job. There
is no question that pupil size is important in refractive surgery."
Later in the thread, Dr. Trattler states, "To be safe - it is nice to
have an ablation zone that is larger than the patient's pupil size -
and that will happen for you if you go with the (LADARVision)." This
statement from Dr. Trattler is a direct confirmation of my advise to
Jim regarding the pupil size issue.
Keller, would you please explain to me and any others reading this
newsgroup why you would deliberately attempt to create the impression
that Dr. Tratter and I disagree on the issue of pupil size and
refractive surgery when in fact we are in agreement?
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
http://www.USAeyes.org
http://www.ComplicatedEyes.org
I am not a doctor.
Richard
news:he4o70dje9rh4fmh9...@4ax.com:
> My guess is that Keller assumes people only read her subject lines
> (which cannot be avoided) and no longer read her posts due to her long
> history of misinformation and anti-refractive surgery/surgeon/industry
> rhetoric.
Actually, when killfiled, you never see the subject either.
--
Richard
serebel
..
>
> Keller, would you please explain to me and any others reading this
> newsgroup why you would deliberately attempt to create the impression
> that Dr. Tratter and I disagree on the issue of pupil size and
> refractive surgery when in fact we are in agreement?
>
I'll explain it, it's Sandy's life calling to be a proffessional Noodge.
The way she twists the truth, she'd be a great editor for the Washington Post.
SErebel
Sandy
Did you write this?
"It is important to note that recent studies have shown that there is
no direct correlation between pupil size and night vision problems."
Does Dr. Trattler agree with your conclusion?
I don't care about all of the other mumbo-jumbo you threw in.
Glenn - USAEyes.org
>
>
>Did you write this?
>
>"It is important to note that recent studies have shown that there is
>no direct correlation between pupil size and night vision problems."
>
>Does Dr. Trattler agree with your conclusion?
>
>I don't care about all of the other mumbo-jumbo you threw in.
I rest my case.
Glenn Hagele
Executive Director
Council for Refractive Surgery Quality Assurance
Email to glenn dot hagele at usaeyes dot org
Sandy
> >
> >
> >Did you write this?
> >
> >"It is important to note that recent studies have shown that there is
> >no direct correlation between pupil size and night vision problems."
> >
> >Does Dr. Trattler agree with your conclusion?
> >
> >I don't care about all of the other mumbo-jumbo you threw in.
>
> I rest my case.
Glenn, all of your other ramblings don't erase that sentence, at least
not where I come from.
Ragnar Suomi
>
>Glenn, all of your other ramblings don't erase that sentence, at least
>not where I come from.
I think you are under the mistaken assumption that anybody cares who
you are and where you come from. All that is important is for people
to realize what you are.. mentally ill.
Glenn - USAEyes.org
There is no need to erase this sentence or anyother. It is accurate.
Recent studies have shown that there is no direct correlation between
pupil size and night vision problems.
Keller, can you reference a study that shows a direct correlation
between pupil size and night vision problems?
Ragnar Suomi
Nobody disputes that night vision problems do happen. How much of a
problem they are is debateable.
What is a shame is that when MissInformation keeps harping away on
pupil size, people are not getting the right information about night
vision problems and how to treat them.
It's interesting to note that the people that complain the most are
also the people who never have a solution for anything.
Glenn - USAEyes.org
>There is no need to erase this sentence or anyother. It is accurate.
>Recent studies have shown that there is no direct correlation between
>pupil size and night vision problems.
It is important to note that I refer to using preoperative pupil size
(alone) as a predictor of night vision problems. Pupil size is a
moderator of night vision problems when they already exist, however
pupil size alone is an unreliable predictor of night vision problems.
For details visit http://www.usaeyes.org/faq/subjects/pupil_size.htm.
Ragnar Suomi
mentally ill before it's a given. Her mind is closed, her motives are
set in stone, and she will never wise up.
All you can do is keep others from being deceived by her. New people
in here looking for information innocently get tangled into her
spider's web and she injects them with her poisonous misinformation.
What amazes me is how far she has to go to find articles that
contradict reality. Just this week, she went back over 10 years to
find something to fit her agenda. Then look at her subject lines
carefully. You will find that they almost always imply something well
beyond what the article she is referencing implys. For example, if
the article said "there were more than 10 complications last year.."
she would have a subject line similar to "What is the true number of
complications? 10 or 10 million?"
On Sat, 17 Apr 2004 00:47:44 -0400, SickRick <S...@com.com> wrote:
>On 14 Apr 2004 22:51:18 -0700, sa...@savvysneaks.com (Sandy) wrote:
>
>Sandy you psycho-bitch. Glenn doesn't say that pupil size isn't
>IMPORTANT, just that the studies that you are quoting are FLAWED
>(according to Trattler) which means that the point that YOU constantly
>are trying to make, using THESE STUDIES AS PROOF, is MOOT.
>
>Which means that: recent studies DO NOT SHOW A CORRELATION BETWEEN
>NIGHT VISION PROBLEMS AND PUPIL SIZE.
>
>Glenn DOES SAY:
>
>3. "Response"
>Posted by Glenn - Sacramento, CA on 16:59:18 1/17/2004
>The key is for the optical ablation zone (full correction) to be equal
>to or larger than the size of your naturally dilated pupil. That is
>the safest route, no matter what the laser.
>It is important to note that recent studies have shown that there is
>no direct correlation between pupil size and night vision problems.
>Some people with pupils larger than the optical ablation zone have
>problems, some do not. Although pupil size alone is a poor predictor
>of night vision problems, the safest route continues to be an optical
>ablation zone equal to or larger than the naturally dilated pupil.
>
>Glenn Hagele
>Council for Refractive Surgery Quality Assurance
>
>Which has been his position all along.
>
>Your continued OBSESSION on this one point, proves your PSYCHOSIS
>beyond the shadow of a doubt. Using these ramblings as evidence would
>probably be sufficient for a judge to enter a finding of INCOMPETANCY
>on your behalf, and send you somewhere to get the rest and care you
>truly deserve.
>
>Trattler COMPLIMENTS GLENN & 'Becca: "Rebecca and Glenn are doing a
>great job." but goes on to say about your precious studies;
>
>"There is no question that pupil size is important in refractive
>surgery. There are major flaws in the studies that have come out
>recently."
>
>He DOESN'T SAY NIGHT VISION, he just says REFRACTIVE SURGERY - but we
>ALL KNEW THIS ALREADY.
>
>Sandy darling - PLEASE - get some HELP. We're BEGGING YOU.
>
>PLEASE...
>
>Rick
>
>
>