Effects of Pupil Size on Functional Outcomes of a Simultaneous Vision Intraocular Lens.

IF 3 3区医学 Q1 OPHTHALMOLOGY

Journal of refractive surgery Pub Date : 2025-07-01 DOI:10.3928/1081597X-20250515-02

Petra Davidova, Klemens P Kaiser, Eva Hemkeppler, Myriam Böhm, Thomas Kohnen

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Abstract

Purpose: To evaluate the relationship between pupil size and subjective visual quality after implantation of a simultaneous vision intraocular lens (IOL).

Methods: Patients after bilateral implantation of a trifocal, diffractive IOL were prospectively included. Three months postoperatively, subjective refraction, UDVA, and axis deviation were measured. Pupil size was obtained with an infrared-based pupillometer (PupilX; Albomed) in scotopic, mesopic, and photopic conditions. Subjective impairment with optical phenomena was surveyed in different lighting conditions.

Results: Fifty-two patients (mean age: 68 years) were included; 54 eyes received non-toric IOLs and 50 eyes received toric IOLs. Preoperative spherical equivalent (SE) was -0.914 diopters (D) (range: -10.00 to +5.92 D) and SE and lens torus were 20.3 D (range: 9.00 to 32.00 D) and 1.65 D (range: 1.00 to 3.75 D), respectively. Three months postoperatively pupil size was 5.42 mm (range: 2.60 to 7.50 mm) in scotopic, 4.24 mm (range: 2.60 to 6.10 mm) in mesopic, and 3.38 mm (range: 1.20 to 5.60 mm) in photopic conditions, spherical manifest refractive error 0.14 D (range: -0.75 to 1.25 D), SE 0.034 D (range: -1.13 to +1.13 D), and UDVA 20/22.4 (range: 20/63 to 20/12.5). In low light conditions, halos correlated weakly with scotopic (r = 0.268, P = .006) and mesopic (r = 0.298, P = .002) pupil size and double-contour with scotopic pupil size (r = 0.234, P = .018). Glare, starbursts, and blurred vision were not influenced in any condition. Further significant influential factors were postoperative spherical manifest refractive error (P = .014), SE (P = .007) and lens torus (P = .029) for halos and preoperative SE (P = .019), postoperative UDVA (P = .035), and lens SE (P = .023) for double-contour. In multiple regression analysis, lens torus, mesopic pupil size, preoperative SE, and postoperative UDVA remained significant.

Conclusions: Pupil size did not play a major role in disturbance with optical phenomena after implantation of a trifocal diffractive IOL. [J Refract Surg. 2025;41(7):e645-e654.].

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瞳孔大小对同步视力人工晶状体功能的影响。

目的：探讨同步视力人工晶状体植入术后瞳孔大小与主观视觉质量的关系。方法：前瞻性纳入双侧三焦衍射人工晶体植入术患者。术后3个月测量主观屈光、UDVA、轴偏度。瞳孔大小用红外瞳孔计(x；在暗、中、光条件下。在不同的光照条件下，观察了主观光学损伤现象。结果：纳入52例患者，平均年龄68岁；非晶状体人工晶状体54眼，晶状体人工晶状体50眼。术前球等效（SE）为-0.914屈光度(D)（范围：-10.00 ~ +5.92 D）， SE和晶状体分别为20.3 D（范围：9.00 ~ 32.00 D）和1.65 D（范围：1.00 ~ 3.75 D）。术后3个月暗瞳5.42 mm（范围：2.60 ~ 7.50 mm），中瞳4.24 mm（范围：2.60 ~ 6.10 mm），光瞳3.38 mm（范围：1.20 ~ 5.60 mm），球面明显屈光差0.14 D（范围：-0.75 ~ 1.25 D）， SE 0.034 D（范围：-1.13 ~ +1.13 D）， UDVA 20/22.4（范围：20/63 ~ 20/12.5）。在弱光条件下，光晕与暗瞳大小（r = 0.268, P = 0.006）、中瞳大小（r = 0.298, P = 0.002）和双轮廓与暗瞳大小（r = 0.234, P = 0.018）相关性较弱。眩光、星光闪烁和视力模糊在任何情况下都不受影响。术后球面明显屈光误差（P = 0.014）、光晕的SE （P = 0.007）和晶状体（P = 0.029）、术前SE （P = 0.019）、术后UDVA （P = 0.035）和双轮廓的晶状体SE （P = 0.023）是进一步显著影响因素。在多元回归分析中，晶状体环面、介眼瞳孔大小、术前SE和术后UDVA仍然显著。结论：三焦衍射人工晶体植入术后，瞳孔大小对光学现象的影响不大。[J].中华眼科杂志，2015;41(7):645- 654。

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来源期刊

$Journal of refractive surgery$

Journal of refractive surgery 医学-外科

CiteScore

5.10

自引率

12.50%

发文量

160

审稿时长

4-8 weeks

期刊介绍： The Journal of Refractive Surgery, the official journal of the International Society of Refractive Surgery, a partner of the American Academy of Ophthalmology, has been a monthly peer-reviewed forum for original research, review, and evaluation of refractive and lens-based surgical procedures for more than 30 years. Practical, clinically valuable articles provide readers with the most up-to-date information regarding advances in the field of refractive surgery. Begin to explore the Journal and all of its great benefits such as: • Columns including “Translational Science,” “Surgical Techniques,” and “Biomechanics” • Supplemental videos and materials available for many articles • Access to current articles, as well as several years of archived content • Articles posted online just 2 months after acceptance.