Investigation Of Factors Affecting Pupillometric Changes After Phacoemulsification
Published 2025 - 43rd Congress of the ESCRS
Reference: FP16.03 | Type: Free paper
Authors: Robert Herber* 1 , Katharina Voeltz 1 , Lisa Ramm 1 , Ahmed Elsheikh 2 , Frederik Raiskup 1 , Ramin Khoramnia 1
1Ophthalmology,University Hospital Carl Gustav Carus,Dresden,Germany, 2School of Engineering Faculty of Science and Engineering,University of Liverpool,Liverpool,United Kingdom
Purpose
It has been shown that cataract surgery causes pupillometric changes. The aim of our study is to examine which patient- or surgery-related factors influence these pupillometric changes occurring after phacoemulsification.
Setting
Retrospective
Methods
This study included 117 eyes of 117 patients who presented to the ophthalmology clinic of Alanya Alaaddin Keykubat University for cataract surgery. In addition to routine preoperative evaluations, nuclear cataract grades, surgery duration (minutes), and the amount of energy used during phacoemulsification (seconds) were recorded. Furthermore, preoperative and postoperative (1st month) pupillometry measurements (scotopic, mesopic, and photopic pupil diameters (PD), in mm) were performed using the Sirius topography device. All surgeries were performed by the same experienced surgeon (FY) using the same device (Bausch+Lomb Stellaris, USA) with the same surgical technique.
Results
Of the included patients,43.6% (n=51) were female, with a mean age of 67.3 years.The mean surgery duration was 13±3.5 minutes, the cataract grade was 2.54±0.9, and the energy used during surgery was as follows: all phaco time (APT) 37.3±26s and effective phaco time (EPT) 3.7±2.6s. Compared to preoperative levels, postoperative scotopic PD decreased by 16.1±11%,mesopic PD by 15±12%, and photopic PD by 12.2±10%. Correlation analyses revealed a positive correlation between age and changes in scotopic and mesopic PD (r=0.2, p=0.03; r=0.19, p=0.03, respectively). Similarly, a positive correlation was found between surgery duration and changes in scotopic, mesopic, and photopic PD (r=0.27, p=0.002; r=0.25, p=0.005; r=0.22, p=0.014, respectively).
Conclusions
In conclusion, it was demonstrated that phacoemulsification surgery results in a reduction of pupil diameter under all lighting conditions. This reduction is directly related to the patient’s age and the duration of the surgery. Since postoperative pupil diameter affects visual quality, considering these factors may enhance surgical success, especially in patients planned for multifocal or extended depth-of-focus (EDOF) intraocular lens implantation.