Posters

Does cataract surgery affect pupillary dynamics?

Poster Details

First Author: P.Cremonesi ITALY

Co Author(s):    G. Coco   N. Menassa   K. Gadhvi   S. Kaye   V. Romano        

Abstract Details

Purpose:

Corneal and intraocular refractive surgeries are widely spread methods to correct ocular refractive errors and their results depend, among other factors, on pupillary diameters. The purpose of this study was to evaluate whether phacoemulsification cataract surgery had an impact on pupillary statics and dynamics measurements.

Setting:

St. Paul’s Eye Unit, Royal Liverpool University Hospital NHS Trust, Liverpool, UK.

Methods:

Retrospective study on 24 patients who underwent phacoemulsification cataract surgery, and for whom pre-operative and 1-month post-operative pupillometry data were available for analysis. Clinical parameters were recorded, as well as surgeon’s grade, level of ultrasound used (cumulative dissipated energy, CDE) and intra-operative complications. Outcomes were changes in static scotopic, mesopic, and photopic pupil diameters. Also, Δ dilation (maximum pupil diameter – pupil diameter at time 0), % of dilation at 3.5 seconds, time to reach 75% and 95% of maximum dilation and speed of dilation (Δ dilation/time to reach maximum dilation) were analysed. Fellow eye served as control.

Results:

Mean age was 73.1 ± 14.6 years, and 13 were males (54%). Mean CDE value was 18.11 ± 10.56. Phacoemulsification cataract surgery significantly determined a negative change of 0.24 ± 0.48 mm in mean scotopic pupil diameters (p = 0.0214), and a decrease 0.03 ± 0.04 mm/s in the average speed of dilation (p = 0.010). The negative change in mean scotopic pupil diameter was also noticed in the fellow eye (0.19 ± 0.44 mm; p = 0.0415). Linear regression showed that level of CDE used during surgery was the only factor significantly associated with both static and dynamic pupillary changes (p = 0.042 and p = 0.044, respectively).

Conclusions:

Phacoemulsification cataract surgery can determine changes in pupillary diameters and their dynamic behaviours. These changes are associated with the CDE level during surgery. Patients with previous corneal refractive surgery or those who are candidate to multifocal/trifocal intraocular lens implant may benefit from low intra-operative ultrasound level.

Financial Disclosure:

None