ESCRS - FP08.08 - In Vivo Characterization Of The Effective Optical Zone And Pupillary Dynamics In Pseudophakic Eyes Using Swept-Source Oct

In Vivo Characterization Of The Effective Optical Zone And Pupillary Dynamics In Pseudophakic Eyes Using Swept-Source Oct

Published 2026 - 44th Congress of the ESCRS

Reference: FP08.08 | Type: Free paper | DOI: 10.82333/p3et-cq58

Authors: Dr Felix Gonzalez-Lopez* 1 , Dr Santiago Delgado-Tirado 1 , Dr Jaime Aramberri 2 , Mr Jose Antonio Calvache-Anaya 3 , Mrs Ana Dominguez-Salas 4 , Mrs Celia Manquillo-Fernandez 4 , Mrs Enelia Cristina Pelaez-Gutierrez 4

1Anterior Segment and Refractive Surgery,MIRANZA,Madrid,Spain, 2Anterior Segment and Refractive Surgery,MIRANZA,Vitoria,Spain, 3Instituto de Oftalmología Quironsalud,Palma de Mallorca,Spain, 4Department of Research and Development,MIRANZA,Madrid,Spain

Purpose

To characterize postoperative pupillary dynamics after femtosecond laser–assisted cataract surgery (FLACS) using dynamic swept-source anterior segment optical coherence tomography (AS-OCT) and to determine their influence on the effective optical zone (EOZ) of intraocular lenses (IOLs) under photopic and scotopic conditions.

Setting

Clínica Miranza IOA, Madrid, Spain

Methods

In this retrospective observational study, 129 pseudophakic eyes of 129 European Caucasian patients undergoing uncomplicated FLACS were analyzed. Dynamic pupil measurements were obtained preoperatively and postoperatively using swept-source AS-OCT (CASIA2) under standardized photopic and scotopic illumination. Iris-plane pupil diameter (IPD), anterior chamber depth (ACD), and lens–iris plane distance (L-IPD) were recorded. EOZ was calculated using a paraxial geometric model incorporating corneal power and anatomical distances. Correlation and multivariable regression analyses were performed to identify predictors of EOZ.

Results

Mean postoperative EOZ measured 2.20 ± 0.47 mm under photopic and 3.66 ± 0.77 mm under scotopic conditions (P < .0001). Under scotopic illumination, 96.9% of eyes exhibited an EOZ < 5.0 mm, and no eye reached 6.0 mm. EOZ showed a strong correlation with preoperative IPD (photopic R = 0.83; scotopic R = 0.84; both P < .0001). In multivariable models, preoperative IPD was the only independent predictor of EOZ under both lighting conditions (photopic R² = 0.748; scotopic R² = 0.757). Other biometric parameters, including L-IPD, ACD, keratometry, axial length, age, and crystalline lens geometry, were not independently associated with EOZ.

Conclusions

High-resolution swept-source AS-OCT enables precise in vivo assessment of preoperative and postoperative pupillary behavior and enables calculation of the functional optical zone of IOLs. In pseudophakic eyes, the EOZ is predominantly determined by pupil size rather than by IOL position or other biometric parameters. Preoperative pupil assessment is therefore critical for optimizing IOL selection and for anticipating postoperative optical performance