Pupillometry Analysis And Its Role In Phacoemulsification With Premium Iols

Published 2023 - 41st Congress of the ESCRS

Reference: PO0545 | Type: Free paper | DOI: 10.82333/9mg1-t714

Authors: Umberto Camellin* ¹ , Massimo Camellin ² , Roberta Di Pietro ² , Pasquale Aragona ¹

¹Ophthalmology,University of Messina,Messina,Italy, ²Sekal Microchirurgia Rovigo,Rovigo,Italy

Purpose

The pupil we measure with today's pupillometers is the image pupil. In fact, the real pupil (at the level of the iris plane) undergoes an enlargement which depends on the anterior chamber and on the cornea curvature.

The study aims to analyze the scotopic (Ps), photopic (Pp) pupil image and pupillary kinetics (Pc [Scotopic - photopic]) image pre and post phacoemulsification with IOL implantation. The calculation of the real pupil (in terms of the IOL implantations) finds implications in the effect that the variation in pupillometry can have on diffractive phenomena after IOL implantation and the influence it can have on the effectiveness of multifocal lenses in intermediate and near vision.

Setting

Sekal Microchirurgia Rovigo, Rovigo Italy and University of Messina, Messina Italy

Methods

Retrospective cohort study of 169 eyes underwent phacoemulsification with IOL implantation. We collected the following data: Age, SimK, pre- and post-operative Anterior Chamber Depth (ACD), Lens Thickness (LT) and Axial Lenght (AL), Ps and Pp and pre- and post-operative Pc at 1 month. Shapiro-Wilk normality tests, Pearson and Spearman correlation and T-student test were conducted with SPSS.

The postoperative real pupil (at iris plane) was calculated using the formula proposed by Bennett and Rabbett (Clin. Vis. Opt. 1989) modified for pseudophakic eyes taking into account the patient's axial length.

Results

Mean values and standard deviations were: age = 65±11.33 years, pre and post ACD 3.34 ± 0.36 and 4.98 ± 0.80 mm respectively (p<.01), LT = 4.55 ± 0.42 mm, Kavg= 42.74 ± 3.22 D, AL= 25.81 ± 2.97 mm, Ps pre and post were respectively 5.33 ± 0.96 and 4.76 ± 0.98 mm (p<.01), Pp pre and post were respectively 3.48 ± 0.73 and 3.25 ± 0.71 mm (p<.01), Pc pre and post were 1.85 ± 0.70 and 1.51 ± 0.78, respectively (p<0.1).

Conclusions

The analysis of the preoperative pupil image alone is not sufficient for a correct indication of the premium IOL to be implanted but must be correlated to biometric parameters such as preop and post ACD and SimK which modify the real pupil size. A correct estimation of the real postoperative pupil size and its kinetics can improve the prediction of the patient's visual outcome in case of IOLs implantation.