Changes of pupil parameters and visual quality after cataract surgery as well as their correlation

To compare the changes of pupil parameters and visual quality after cataract surgery and explore their potential correlations.

This retrospective cohort study analyzed clinical data of Han Chinese patients who received cataract surgery from June 2016 to October 2016. Visual acuity, pupil size, pupil shift, wavefront aberrations, point spread function (PSF), and modulation transfer function (MTF) were detected preoperatively, 1d and 1mo postoperatively. Pupil parameters and visual outcomes were compared across the three time points.

A total of 110 eyes from 110 patients (42 males and 68 females) were enrolled, with a mean age of 66.8±7.9y (range: 53-88y). Under both photopic and mesopic conditions, pupil diameter and pupil shift at 1d and 1mo after surgery were significantly lower than baseline levels. Corneal aberrations decreased postoperatively. Photopic and mesopic modulation transfer function derived from higher-order (HO) aberrations increased significantly from postoperative day 1 to postoperative month 1. Pupil size was positively correlated with wavefront aberrations, and negatively correlated with total PSF and HO-PSF. Significant correlations were identified between preoperative pupil diameter and 1-month postoperative visual quality indicators (including aberrations, PSF and modulation transfer function). A preoperative mesopic pupil diameter over 5.60 mm effectively predicted poor 1-month postoperative visual quality (HO aberrations >0.5 µm), with an area under the curve (AUC) of 0.71.

Pupil parameters and visual quality alter significantly after cataract surgery, and moderate correlations exist between pupil diameter and visual quality at each time point. Preoperative pupil diameter is correlated with 1-month postoperative visual quality.