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Change in pupil size using the low-energy femtosecond laser Ziemer Z8 in cataract surgery

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Session Details

Session Title: Femtolaser-Assisted Cataract Surgery (FLACS) I

Session Date/Time: Sunday 08/10/2017 | 08:00-10:00

Paper Time: 09:40

Venue: Room 3.6

First Author: : A.Mirshahi GERMANY

Co Author(s): :                        

Abstract Details


To assess the change in pupil size during femtosecond-laser assisted cataract surgery (FLACS) using a low-energy laser system


Dardenne Eye Hospital, Bonn, Germany


In a case series we measured the pupil sizes of 35 eyes (35 patients, mean age: 74.8 y, range: 51–87) undergoing FLACS using the Ziemer LDV Z8 system by extracting pictures out of the laser software after each of following steps: application of suction, lens fragmentation and capsulotomy. Furthermore, the pupil diameters were measured on the basis of images taken preoperatively, after releasing the suction and at the end of the surgery. Changes in the pupil size were determined by assessing horizontal and vertical diameters of the pupil. A one-way ANOVA and post-hoc tests were used for statistical analyses.


Mean preoperative width was 7.69±0.66 mm horizontally and 7.80±0.64 vertically. Neither was there a statistically significant effect of laser steps on pupil diameter [F(5,204)=4.71, Tukey post-hoc p=0.89 horizontal axis and [F(5,204)=3.36Tukey post-hoc p=0.89 vertical], nor when comparing pre-laser to post-laser pupil sizes (Tukey post-hoc p=0.89 horizontal axis and vertical) . However, the mean pupil size decreased by 0.52 mm (range: 0.006-1.773 horizontal and 0.014-1.84 vertical) after application of the suction (Tukey’s and Bonferroni Holm post-hoc tests, p=0.02 for horizontal and p=0.03 vertical) followed by a mean increase of 0.54 mm (range: 0.052-1.995 mm horizontal and 0.006-2.111 vertical) after release of suction.


Low-energy femtosecond laser capsulotomy and lens fragmentation were not associated with progressive pupil narrowing. However, there was a suction-related decrease in pupil diameter of approximately 0.5 mm which disappeared after the removal of the interface, resulting in a pupil diameter that was not significantly different from the preoperative state.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented

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