Changes In Pupil Diameter And Pupillary Light Reflex In Different Lighting Conditions After Icl Implantation And Their Effect On Vault

To assess the changes in pupil diameter and pupillary light reflex under different lighting conditions after ICL implantation, and to evaluate the impact of these changes on vault.

The magnitude of early postoperative vault changes following ICL implantation varies, and the influencing factors are worth exploring. Different pupil diameters under varying lighting conditions have an impact on postoperative vault, and the changes in pupil size after ICL surgery are worthy of investigation.

A total of 42 eyes from 21 patients who underwent EVO ICL implantation were followed up. The routine preoperative and postoperative examinations. All patients underwent pupil size measurement under different light conditions of 0.04 lux, 0.4 lux, and 40 lux to simulate dark, dusk, and bright environments, respectively after adapting to the dark environment. The left and right eyes were stimulated separately with 40 lux light intensity for 0.2 seconds, and the amplitude, time, and speed of constriction and dilation of both eyes were measured to obtain the results of direct and consensual pupillary light reflexes. Statistical analysis using SPSS 20.0, P value <0.05 was considered statistically significant.

One week after surgery, there was no significant difference in pupil diameter under dark conditions (P = 0.17); pupil diameters under dusk (P < 0.0001) and bright conditions (P = 0.0001) were significantly smaller than those before surgery, and pupil mobility showed a significant increase from preoperative levels (P = 0.004). Both direct (P =0.02) and indirect (P < 0.0001)pupillary light reflex rates of the operated eye were significantly decreased.The change in vault from the first day to the first week after surgery showed a significant strong positive correlation with preoperative dark pupil diameter (r=0.56, p=0.002), but no statistical correlation with preoperative pupil diameter under dusk conditions or under bright light (p>0.1).

The diameter of the dark pupil is significantly correlated with the early postoperative decrease in vault, which needs to be considered when selecting the ICL size. The weakened pupillary light reflex rate in the early postoperative period after ICL surgery requires longer-term observation to assess its impact.