Abstract
Purpose :
Atonic pupil has been reported as a rare complication following cataract surgery. We had clinically observed significant decrease in the maximum pupil dilatation following uneventful cataract surgery in patients. The purpose of our study was to prospectively assess if uncomplicated cataract surgery may result in iris dysfunction with reduced or poor dilation and changes in dynamic pupillary response.
Methods :
Prospective, single center, IRB approved observational study of pupillary function (using a Colvard pupillometer). Pupil size was measured in ambient room light, under scotopic conditions, and following standard mydriasis prior to and three or more weeks after uneventful cataract extraction by phacoemulsification using an Alcon Infinity unit. Demographics, cataract type and grade, iris color, and cumulative dissipated energy (CDE) was evaluated. Subjects with preexisting conditions predisposing to pupillary dysfunction were excluded.
Results :
75 eyes from 52 subjects were included in the study. 50% of participants were female. The mean age was 71.9 ± 9.7 years (range of 44-92 years). There was a significant reduction in mean mydriatic pupillary dilation post-surgery (-0.73mm±1.12 mm and 10±14%, p=0.030) and a correlation to the CDE (r=0.258, p=0.040). There was up to a 40% reduction in some cases. There was no association with iris color, nuclear cataract density, or age. Analysis of dynamic pupil response data is ongoing.
Conclusions :
There can be a prolonged and significant decrease in pupillary dilation following uncomplicated cataract extraction. Poor dilation (<6 mm) or pupillary disfunction can impact examination of the posterior segment and could also possibly impact performance of some multifocal intraocular lenses. The mechanism for pupillary dysfunction is yet unclear, but investigation is ongoing and will be discussed.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.