The evaluation of pupil diameter by using Sirius before and after phacoemulsification in healthy, diabetic and hypertension patients

BACKGROUND

Pupil size can affect the selection of the ablation region in refractive surgery and intraocular lens design in cataract surgery. Therefore, the evaluation of pupil diameter (PD), one of the anterior segment parameters, is an important component of ophthalmological examination.

MATERIAL AND METHODS

Seventy-one healthy patients, 64 patients with Systemic Hypertension (HT), and 65 patients with Diabetes Mellitus (DM) scheduled for phacoemulsification were included in the study. PD was measured before and one month after surgery using combined Scheimpflug-Placido disk topography (Sirius, CSO Inc.). Preoperative PD values of the groups were compared. The PD of the groups was compared in the 1st month after surgery. Then, preoperative and postoperative pupil diameter values of the groups were compared. The effect of the surgery on the change in pupil diameter (effect value) in the groups was also examined.

RESULTS

Pre- and postoperative PD only differed significantly between the healthy and DM groups (P = .039 and P = .045, respectively). PD decreased in all three groups after phacoemulsification. Pre-and postoperative PD differed significantly in the healthy group (4.78 ± 0.94 and 3.01 ± 0.48 mm, respectively, P < .05). Pre- and postoperative PD values also differed significantly (4.69 ± 0.84 and 2.95 ± 0.42 mm, respectively, P < .05). In the DM group, Pre- and postoperative PD also differed significantly in the DM group (4.38 ± 1.08 and 2.82 ± 0.43 mm, respectively, P < .05). The effect values of PD changes differed in the healthy, DM, and HT groups (1.95, 1.41, and 2.28, respectively). Phacoemulsification was observed to have a greater effect on PD change in HT patients.

CONCLUSIONS

PD was smaller in DM patients than in the other groups. PD decreased in all three groups after phacoemulsification. This change should be remembered when planning cataract surgery for chronic metabolic patients.

Clear-cornea cataract surgery: pupil size and shape changes, along with anterior chamber volume and depth changes. A Scheimpflug imaging study

PURPOSE

To investigate, by high-precision digital analysis of data provided by Scheimpflug imaging, changes in pupil size and shape and anterior chamber (AC) parameters following cataract surgery.

PATIENTS AND METHODS

The study group (86 eyes, patient age 70.58±10.33 years) was subjected to cataract removal surgery with in-the-bag intraocular lens implantation (pseudophakic). A control group of 75 healthy eyes (patient age 51.14±16.27 years) was employed for comparison. Scheimpflug imaging (preoperatively and 3 months postoperatively) was employed to investigate central corneal thickness, AC depth, and AC volume. In addition, by digitally analyzing the black-and-white dotted line pupil edge marking in the Scheimpflug "large maps," the horizontal and vertical pupil diameters were individually measured and the pupil eccentricity was calculated. The correlations between AC depth and pupil shape parameters versus patient age, as well as the postoperative AC and pupil size and shape changes, were investigated.

RESULTS

Compared to preoperative measurements, AC depth and AC volume of the pseudophakic eyes increased by 0.99±0.46 mm (39%; P<0.001) and 43.57±24.59 mm(3) (36%; P<0.001), respectively. Pupil size analysis showed that the horizontal pupil diameter was reduced by -0.27±0.22 mm (-9.7%; P=0.001) and the vertical pupil diameter was reduced by -0.32±0.24 mm (-11%; P<0.001). Pupil eccentricity was reduced by -39.56%; P<0.001.

CONCLUSION

Cataract extraction surgery appears to affect pupil size and shape, possibly in correlation to AC depth increase. This novel investigation based on digital analysis of Scheimpflug imaging data suggests that the cataract postoperative photopic pupil is reduced and more circular. These changes appear to be more significant with increasing patient age.