Estimation of pupil size at iris plane and its magnification after cataract surgery

To estimate the pupil size (at the iris plane) under photopic (P PH ) and scotopic (P S ) conditions after phacoemulsification with intraocular lens (IOL) implantation.

190 virgin eyes from 190 patients who underwent cataract surgery with IOL implantation. Data collected with Aladdin (Topcon), AS-OCT MS-39 (CSO), and iTrace (Tracey) were SimK, mean pupillary power at 6 mm (MPP), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), lens rise (LR), P PH and P S before and after surgery at 30 days, dysfunctional lens index, and opacity grade. The position of the postoperative iris plane (PIP) was measured manually with MS-39, and a multivariate regression formula was developed to predict it. Statistical analysis was performed using Statistical Package for Social Science (SPSS) (IBM).

The mean and standard deviations were 42.61 ± 3.20 D for MMP at 6 mm, 3.35 ± 0.37 mm for ACD, 3.89 ± 0.18 mm for PIP ( P < 0.01), 4.55 ± 0.42 mm for LT, 0.43 ± 0.24 mm for LR, and 25.91 ± 3.03 mm for AL. The mean preoperative and postoperative topographic pupil magnification was 12% and 14.22%, respectively ( P < 0.01). Despite an increase in magnification, the postoperative pupil was smaller than the preoperative one both for scotopic and photopic conditions: The larger the preoperative pupil, the more it tends to reduce in the postoperative period.

Analysis of the preoperative topographic pupil alone is not sufficient for a correct indication of the optical zone and total diameter of IOL to be implanted but must be correlated with biometric data. The topographic pupil, therefore, undergoes a change in magnification from the preoperative period to the postoperative period. Furthermore, the real pupil presents a modification and, in most cases, tends to be smaller postoperatively in both photopic and scotopic conditions.