September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Effect of pupil size on visual performance of presbyopes with small-aperture corneal inlay
Author Affiliations & Notes
  • Srividhya Vilupuru
    Clinical and Regulatory, AcuFocus Inc, Irvine, California, United States
  • Ling Lin
    Clinical and Regulatory, AcuFocus Inc, Irvine, California, United States
  • Footnotes
    Commercial Relationships   Srividhya Vilupuru, AcuFocus (E); Ling Lin, AcuFocus Inc (E)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4872. doi:
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      Srividhya Vilupuru, Ling Lin; Effect of pupil size on visual performance of presbyopes with small-aperture corneal inlay. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4872.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : The effects of photopic pupil size on visual acuity and mesopic pupil size on visual symptoms were evaluated in naturally emmetropic presbyopes with a small-aperture corneal inlay implanted in the non-dominant eye for the treatment of presbyopia.

Methods : This was a prospective, non-randomized study of 154 subjects (age 45-60 years) at 12 months postoperative. Eligible subjects had a preoperative spherical equivalent refractions of +0.50 to -0.75 D; best-corrected distance acuity of 20/20 and uncorrected near acuity of 20/40 to 20/100. Corneal inlays were implanted into stromal pockets created with femtosecond laser using spot/line settings of 6x6 microns or less. Photopic and mesopic pupil sizes were measured using a pupilometer to the nearest half-millimeter. Uncorrected visual acuities at distance (UDVA) and near (UNVA) were measured in ETDRS letters. Visual symptoms of glare, halos and night vision problems were rated by subjects from 0 (none) to 7 (very severe). For analyses, photopic and mesopic data sets were each divided into two groups: greater than average (group 1) and less than or equal to average (group 2). Further, a large pupil size group was defined as being two or more standard deviations (SDs) above average.

Results : Mean photopic pupil size was 4.4 ± 0.88 mm; UDVA for photopic pupil size groups 1 and 2 were 49.8 ± 4.8 and 50.9 ± 4.3 letters, respectively and UNVA were 41.0 ± 7.1 and 42.2 ± 8.1 letters, respectively. The between-group differences were not statistically significant (p=0.14 for distance and 0.34 for near). Mean mesopic pupil size was 5.9 ± 0.93 mm; for mesopic pupil groups 1 and 2, the mean ± SD severity of halos was 1.1 ± 1.4 and 0.83 ± 1.5, glare 0.92 ± 1.3 and 0.64 ± 1.3 and night vision 0.87 ± 1.3 and 0.99 ± 1.6, and the between-group differences were not statistically significant (p=0.32, 0.18 and 0.61, respectively). In subjects with the largest pupils (about 5%), acuity was 2-3 letters and symptoms were 1 rating level worse.

Conclusions : Pupil size has none to minimal impact on visual acuity and visual symptoms in the eye implanted with the small-aperture corneal inlay. Subjects with the largest pupils tended to show slightly worse outcomes, however, these trends were not statistically or clinically significant.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.


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