The Influence Of Pupil Diameter In The Determination Of Crystalline Equatorial Plane And Lens Tilt With A Ss-Oct Biometer.
Published 2023 - 41st Congress of the ESCRS
Reference: PP22.04 | Type: Free paper | DOI: 10.82333/1018-t828
Authors: Daniel Romero-Valero* 1 , Pere Climent-Soler 2 , Jose juan Martínez-Toldos 2 , Carlos Enrique Monera-Lucas 2 , Ruben Toledano-Martos 2 , Jorge Luciano Alió 3
1Ophthalmology,General University Hospital of Elche,Elche,Spain;Ophthalmology,Miguel Hernandez University,San Juan,Spain, 2Ophthalmology,General University Hospital of Elche,Elche,Spain, 3Ophthalmology,Vissum Ophthalmological Institute Alicante,Alicante,Spain;Ophthalmology,Miguel Hernandez University,San Juan,Spain
Purpose
Crystalline Lens Equatorial Plane (LEP) has been proposed as a possible parameter for predicting postoperative intraocular Lens position. The purpose of this study is to assess the influence of pupil diameter in the determination of LEP and lens tilt.
Setting
General University Hospital of Elche (Spain); Miguel Hernández University (Spain)
Methods
This transversal study included patients with biometry performed with Anterion (Heidelberg Engineering, Germany) with a measured midriasis ≥6 mm. Anterior segment SS-OCT images at 0-180º were analysed with a custom made software developed in Python 3.10. LEP was defined as the intersection of the anterior and posterior lens surfaces. Anterior segment SS-OCT images were segmented to emulate different pupil sizes (from 3 mm to 6 mm in 0.5mm steps). Lens tilt and LEP was measured for each pupil size analysed.
Results
Two hundred eyes from 137 patients were included. Mean age was 63.15±5.33 years. Mean pupil diameter (PD) was 6.67±0.23. Mean LEP with 6 mm PD was 5.025±0.297 mm. A statistically significant difference was found between 3.0 mm and 6 mm (mean difference 0.018±0.122 mm [0.001 - 0.035] , P = 0.036). No statistical difference was found for LEP between midriasis of 3.5 mm (mean difference 0.008±0.095 mm [-0.005; 0.022], P = 0.21) or larger (p> 0.07) and LEP for PD of 6 mm. Mean IOL tilt for 6 mm was 86.787±2.537º [78.758 – 94.554]. A statistically significant difference was found between lens tilt at 6 mm PD and at PD 3.0, 3.5, 4.0, 4.5 and 5.0 mm (max mean difference (PD = 3.0) 0.111±0.324º [0.660-0.156] P<0.001).
Conclusions
Lens tilt and LEQ are influenced by PD. The effect of PD in these parameters was found to be higher for PD under 3.5 mm. Thus, to evaluate these parameters with Anterion SS-OCT biometer a minimum PD of 3.5 mm is suggested. Future studies will be needed to assess the relevance of the difference found in this study in the determination of effective lens position.