In my practice, no matter which laser I use, I always document that I have measured the size of the patient’s pupil. In today’s medicolegal environment, this step is immensely important, whether it is performed with a Colvard pupillometer (OASIS Medical, Inc., Glendora, CA) or a more sophisticated Procyon infrared pupillometer (Keeler Instruments Inc., Broomall, PA). I personally believe that with the current Wavefront Optimized (WaveLight, Inc., Sterling, VA) and wavefront-guided ablation technologies, pupillary size is a nonissue. Both modalities minimize the induction of spherical aberration. Moreover, Schallhorn et al1 conducted a study in young naval pilots that concluded that night vision problems are unrelated to the pupil’s size. Refractive surgeons used to debate the optimal ablation zone and treatment pattern—optimized versus customized versus conventional ablations and 6.5- versus 7.0-mm treatment zones. The current consensus favors a 6.5-mm treatment zone with either Wavefront Optimized or wavefront-guided technology (to minimize induced spherical aberrations). Holladay et al2 used the Stiles-Crawford effect to explain that even if the effective treatment zone is less than 6.5mm, patients with large pupils do not experience night vision problems as long as the ablation references the wavefront and the zone is at least 6.5mm. The WaveLight ALLEGRETTOWAVE excimer laser (WaveLight, Inc.) features both wavefront-guided and Wavefront Optimized technologies and also delivers a 6.5-mm treatment zone to further prevent unwanted visual symptoms.