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Published on: July 19, 2012
[Pupil centroid shift: Marketing tool or essential clinical parameter?]
I Fischinger1, T G Seiler, G Schmidinger
1Institut für Refraktive und Ophthalmo-Chirurgie (IROC), Stockerstr. 37, 8002, Zürich, Schweiz, isaak.fischinger@hotmail.com.
Background:
Pupil centroid shift (PCS) is an easily measured parameter which is rarely taken into consideration when planning surgery.
Purpose:
The aim of this study was to determine the physiological range of PCS and to evaluate its role in refractive and cataract surgery.
Methods:
The pupil center was measured in 103 eyes of 103 patients using the newest PCS module of the Allegro Topolyzer Vario (Version 1.76r58, Wavelight-Alcon, Erlangen, Germany) and the difference between a mesopic and a photopic environment was determined as PCSm. Additionally, these measurements were linearly extrapolated to pupil diameters of 2 mm and 7 mm (photopic-scotopic, PCSe). The statistical analysis included correlations between various demographic and topographic parameters and PCS.
Results:
The average (± standard deviation) PCSm was 0.12 ± 0.08 mm with a range of 0.02-0.53 mm, with 2 eyes out of 95 (2%) having a PCSm of more than 0.4 mm. The extrapolated PCSe was 0.24 ± 0.16 mm and ranged from 0.03 to 0.78 mm, with 14 eyes out of 95 (15%) having a PCSe of more than 0.4 mm. Of the 95 eyes 3 (3%) showed a PCSe of more than 0.7 mm. There was no correlation between PCS with any of the demographic parameters tested.
Conclusion:
Up to 15% of the patients showed a PCS of more than 0.4 mm which requires a decision of the (refractive) ophthalmic surgeon as to whether the optical zone should be centered on the photopic or mesopic/scotopic pupil center. In the 3% of patients with a PCSe value greater than 0.7 mm, the implantation of multifocal intraocular lens (IOL) is not recommended.
