Corneal HOA’s - Why use 6 mm

A case presentation to illustrate the question of why to use the 6mm corneal zone for evaluating HOAs.

[@LASIKsecondopinion]

Every single person considering refractive surgery should watch this. The current standard of care that ignores pupil size is criminal, not that even people with small pupils should get these surgeries when you consider the much worse complications like corneal neuropathic pain.

[@jaden6781]

Yep. I wish I didn't get my LASIK. endless night vision issues 10 months later and I'm back in glasses

[@K00711]

​@jaden6781 i got smile surgery before 10 months, got high order aberrations, quality of vision is poor, spectacle improved vision, but doctors advising another surgery to correct aberrations, i don't know what to do

[@LASIKsecondopinion]

@@K00711 whatever you do don't get another refractive surgery. Secondary surgeries are riskier, less predictable, and not FDA approved. Optometrists who have seen these cases know additional refractive surgery won't fix the original problem, and often introduces new complications.

[@anciyanazar7651]

@@K00711hi i did relex smile 1 month back .. i strted having distorted and blurred vision during morning and double vision of text on screen and dark background.. my doctor said i have developed a HOA coma and it usually resolves within 3 months .. hw did it go for you .. pls reply

[@OperationDecoded]

And then there are patients who have 9 mm pupils under regular daylight and had refractive surgery and surgeons told them it would be fine. What's your advice there doc?

[@subhabratabhattacharya5492]

The light bends as it passes through the anterior cornea considerably (refraction). Therefore the marginal rays passing through a, say 5/6 mm pupil will bend and may pass through a 3 to 4 mm pupil. The light does not pass through a straight line as it passes through cornea. Therefore a 1:1 relationship between cornea and pupil is not ideal. Just because the pts pupil is 3 mm in mesopic condition, does not mean that only rays pass through the 3 mm of cornea will only be relevant.

[@미정김-t2g]

wow doctor thank you for this informative video!

[@eriksxo]

Lasik destroyed her eyes

[@alweek]

One other reason for using 6mm could also be, that iol optics are typically 6mm diameter. So optics engineers that design those lenses "think" in terms of 6mm. And this way of thinking percolates down through the process, to the sales material, to the lens rep, to the doctor My 2cents

[@1953childstar]

Very informative !!!!

[@Berfo1]

I wonder is this now common knowledge in ophthalmology to look at pupil size/night pupil size?

[@ahmedyoussef6497]

The reason is.. that all Zernicke polynomials are based on 6mm zone.

[@K00711]

Those Abberation are caused by refractive surgery