Effect of preoperative pupil size on quality of vision after wavefront-guided LASIK

To evaluate the effect of preoperative pupil size on quality of vision after wavefront-guided LASIK.

Prospective study.

One hundred two eyes.

LASIK for mild to moderate myopia or astigmatism (preoperative manifest spherical equivalent, -3.99±1.42 diopters).

Questionnaires evaluating specific visual symptoms before and after surgery. Each eye was evaluated before surgery, and 1 week and 1, 3, 6, and 12 months postoperatively. Pupils were stratified according to size: small (≤5.5 mm), medium (5.6-6.4 mm), or large (≥6.5 mm). Mesopic pupil size and preoperative and postoperative variables were evaluated using an analysis of variance. A regression model was also performed to determine the correlation between mean spherical equivalent and cylinder and visual symptoms.

In the early postoperative period, there was no difference between the 3 groups with regard to any of the symptoms. At the final 12-month postoperative visit, patients with medium pupils experienced less glare at night than small pupils (P = 0.02), medium pupils had less halos than small or large pupils (P = 0.001 and P = 0.02, respectively), and medium pupils experienced greater satisfaction in visual improvement than small pupils (P = 0.014).

Twelve months after wavefront-guided LASIK surgery, large pupil size does not positively correlate with any postoperative visual symptoms.