What Does Preoperative Pupil Size Tell Us?

The aim is to analyse preoperative dilated pupil size in patients undergoing cataract surgery.

University Department of Ophthalmology, University Hospital Centre Sestre milosrdnice, Zagreb, Croatia

We analysed patients who underwent cataract surgery at University Clinic Sestre milosrdnice  performed between April 2022 and December 2022. Following data were analysed: sex, age, ophthalmological conditions, systemic diseases, medications being taken at the time of the surgery, and preoperative pupil size. After dilatation with tropicamide 0.5% and phenylephrine hydrochloride 5% drops a phaco with intraocular lens implantation was performed. At the time of surgery eyes with IFIS were indentified using criteria of Chang and Campbel.

A total of 488 eyes were enrolled in the study and all patients underwent uncomplicated cataract surgery. Hypertension and diabetes mellitus were two common diseases, more than half of the patients (54%) were diagnosed with diabetes mellitus, while 48% were diagnosed with hypertension. BPH affected 8.2% of patients. IFIS was observed in 12% eyes, 21.6% has an  IFIS grade 1, 51.6% had an IFIS grade 2, and 26.6% had a full IFIS. The pupil size was 7.8+/-3.3 mm in non-IFIS patients. IFIS patients had statistically narrower pupil size (6.1+/-1.5 mm).

Patients with decreased dilated pupil diameter preoperatively had a higher risk of IFIS development.