Impact Of Pupil Size On Defocus Curve, Contrast Sensitivity And Patient Satisfaction In A Simultaneous Vision Intraocular Lens

To evaluate the relationship between pupil size (PS) and defocus curve, contrast sensitivity (CS) and patient satisfaction after implantation of a simultaneous vision intraocular lens (IOL).

Department of Ophthalmology, Goethe-University, 60590 Frankfurt, Germany

Patients with healthy eyes after bilateral implantation of a trifocal, diffractive IOL were prospectively included. Three months postoperatively, monocular defocus curve, pupillometry (PupilX, Albomed) in mesopic and photopic conditions and binocular CS (photopic, mesopic with and without glare) and patient satisfaction in daily activities (driving day/night, TV, theater, home, PC, newspaper, cooking, domestic work) were obtained. PS was categorized in small (A), medium (B) and large (C).

Fifty-two patients (mean 68 years) were included. Three months postoperatively PS was 4.24 mm (2.60-6.10) in mesopic and 3.38 mm (1.20-5.60) in photopic conditions. In mesopic conditions, 41 eyes had small, 48 medium-sized and 15 large pupils, in photopic conditions 10, 76 and 18 eyes respectively.

 The range of depth-of-field (RoF) for CDVA with visual acuity <= 0.2 logMAR was 4.25 D for A, 3.70 D for B, 3.25 D for C and for <= 0.3 logMAR 5.00 D for A, 4.26 D for B and 3.97 for C in photopic conditions. For mesopic PS it was 3.88 D, 3.61 D, 3.33 D and 4.44 D, 4.22 D and 4.03 D respectively (all p<0.001). The smaller the PS, the bigger the RoF. CS and daily activities did not correlate with PS in any condition.

PS affects RoF significantly but not contrast sensitivity nor patient satisfaction after implantation of a trifocal, diffractive IOL.