Posters

Factors influencing pupil behavior during femtosecond laser-assisted cataract surgery

Poster Details

First Author: M.Popiela UK

Co Author(s):    T. Young-Zvandasara   P. Nidamanuri   H. Popiela   V. Kumar           

Abstract Details

Purpose:

Femtosecond laser assisted cataract surgery is associated with pupillary constriction. This study aims to look at patient and surgical factors predisposing to abnormal pupil behaviour during FLACS.

Setting:

Princess of Wales Hospital, Bridgend, UK

Methods:

This prospective observational study included all patients undergoing FLACS in the Princess of Wales Hospital, Bridgend, UK between February and June 2017. Pupils were measured with a ruler at three time points; immediately before and after laser pre-treatment, and at the start of surgery. Pupil behaviour during surgery was noted in descriptive terms, patient demographic, co-morbidities, eye measurements, suction on time, shifting time and laser energy levels were recorded.

Results:

Seventy- three eyes were included. Average patient age was 74.84 +/- 9.1 years. Mean horizontal pupil sizes immediately before and after femto pre-treatment were 7.87 +/- 0.87mm and 7.7 +/- 0.89mm respectively (P<0.0005). Mean horizontal pupil size at the start of surgery was 6.83 +/-1.43 mm (P<0.0005). Short capsulotomy – pupil distance (P=0.01), shallower anterior chamber (P=0.0012), smaller pre-operative pupil size (P= 0.045) and longer suction on time (P= 0.0019) were significantly associated with intra-operative miosis during FLACS. Sustained mydriasis was observed in eyes in whom topical diclofenac was used within 2 hours of surgery.

Conclusions:

FLACS can result in significant pupil miosis. Eyes particularly at risk are ones with smaller pre-operative pupils and shallower anterior chambers and those subjected to longer suction on time. Well- timed NSAIDs application could be protective against this phenomenon.

Financial Disclosure:

None