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Pupil size and corneal laser surgery.
James J Salz1, William Trattler
1University of Southern California and Los Angeles County Medical Center, Los Angeles, California 90048, USA. jjsalzeye@aol.com
Current Opinion in Ophthalmology
|August 11, 2006
Summary
Large scotopic pupil size may predict night vision complaints, though research is conflicting. Refractive surgeons should inform patients of this potential risk factor for better outcomes.
Area of Science:
- Ophthalmology
- Optometry
Background:
- Scotopic pupil size is a debated factor in predicting night vision complaints.
- Existing literature presents conflicting findings on the correlation between pupil size and visual disturbances.
Purpose of the Study:
- To review and summarize existing literature on the relationship between scotopic pupil size and night vision complaints.
- To assess the controversial role of pupil size in predicting postoperative visual symptoms.
Main Methods:
- Literature review of studies investigating scotopic pupil size and night vision complaints.
- Discussion of pupil-measuring devices, informed consent, and wavefront aberrations.
- Analysis of objective measurements correlating pupil size with starbursts and treatment outcomes.
Main Results:
- Wavefront aberrations increase with pupil size.
- A new device showed correlation between pupil size and starbursts, with wavefront-guided treatments reducing them.
- Cortical adaptation aids many patients, but symptomatic individuals may benefit from pupil-reducing drops or retreatments.
Conclusions:
- Conflicting reports necessitate informing patients about large scotopic pupil size as a potential risk factor.
- Advising patients aligns with recommendations from VISX, Alcon, and the FDA.
- Refractive surgeons should proactively manage patient expectations regarding night vision after procedures.