Hagele posted the following on alt.lasik-eyes



Of course pupil size alone is not a predictor of NVD. There are two factors: 1) pupil size, 2) effective optical zone. It's the negative clearance (pupil size exceeds effective optical zone) that's the problem. Hagele, are you really that stupid?

What if lasers still employed a 4 mm optical zone? We'd have a lot more patients with NVD, wouldn't we? Why? Because more patients would have negative clearance, because most patients' scotopic pupils exceeds 4 mm.

This is grade-school level stuff that Hagele won't acknowledge.

Since, according to Hagele, this issue is hotly debated (with the overwhelming majority firmly in the "pupil size matters" camp), why would he, as a "patient advocate" not insist on the safest surgical approach for patients?

Lindstrom is placing patients at risk, and that's ok with Hagele?

You won't get a real answer from Hagele on this anytime soon. When confronted with the fact that his "certified" surgeon, Dr. Lindstrom isn't properly screen patients, he basically recited Dr. Lindstrom's biography.

The fact is that Hagele has a history of providing bogus "certifications" to some of the worst doctors in the industry, simply to bring in cash to support his lifestyle which includes ownership of luxury automobiles such as "Rolls Royce, Jaguar, Triumph, and even a DeSoto or two."

If pupil size doesn't matter, why prescribe eye drops (Alphagan, Pilocarpine) to constrict the pupil at night to reduce the symptoms of NVD? Either pupil size matters or it doesn't. They can't have it both ways.

The truth is, when miotic eye drops are instilled, in most cases the pupil becomes smaller than the effective optical zone, and the negative clearance is eliminated. When this happens the patient has a significant improvement in visual quality.

Shame, shame, shame on you, Hagele for misleading patients into believing that choosing a CRSQA surgeon will increase their odds of having a good outcome.

J Cataract Refract Surg. 2005 Dec;31(12):2272-80.

Influence of pupil and optical zone diameter on higher-order aberrations after wavefront-guided myopic LASIK.

CONCLUSION: The OZ zone to pupil ratio (fractional clearance) had a significant impact on HOA induction after wavefront-guided LASIK.



Glenn uses spin to try to coverup the importance of pupil size by saying that "pupil size alone is a poor predictor of NVD". No kidding. It's pupil size in relation to the optical zone treated by the laser. Glenn needs to read the entire text of this peer-reviewed article. It even provides the explanation for how Pop and Schallhorn got it wrong!