Linke Stephan J, Baviera Julio, Munzer Gur, Fricke Otto H, Richard Gisbert, Katz Toam
Department of Ophthalmology, University Medical Centre Hamburg-Eppendorf, Martinis, Hamburg, Germany.
Optom Vis Sci. 2012 Aug;89(8):1156-64. doi: 10.1097/OPX.0b013e318263c165.
To evaluate factors that may affect mesopic pupil size in refractive surgery candidates.
Medical records of 13,959 eyes of 13,959 refractive surgery candidates were reviewed, and one eye per subject was selected randomly for statistical analysis. Detailed ophthalmological examination data were obtained from medical records. Preoperative measurements included uncorrected distance visual acuity, corrected distance visual acuity, manifest and cycloplegic refraction, topography, slit lamp examination, and funduscopy. Mesopic pupil size measurements were performed with Colvard pupillometer. Relationship between mesopic pupil size and age, gender, refractive state, average keratometry, and pachymetry (thinnest point) were analyzed by means of ANOVA (+ANCOVA) and multivariate regression analyses.
Overall mesopic pupil size was 6.45 ± 0.82 mm, and mean age was 36.07 years. Mesopic pupil size was 5.96 ± 0.8 mm in hyperopic astigmatism, 6.36 ± 0.83 mm in high astigmatism, and 6.51 ± 0.8 mm in myopic astigmatism. The difference in mesopic pupil size between all refractive subgroups was statistically significant (p < 0.001). Age revealed the strongest correlation (r = -0.405, p < 0.001) with mesopic pupil size. Spherical equivalent showed a moderate correlation (r = -0.136), whereas keratometry (r = -0.064) and pachymetry (r = -0.057) had a weak correlation with mesopic pupil size. No statistically significant difference in mesopic pupil size was noted regarding gender and ocular side. The sum of all analyzed factors (age, refractive state, keratometry, and pachymetry) can only predict the expected pupil size in <20% (R = 0.179, p < 0.001).
Our analysis confirmed that age and refractive state are determinative factors on mesopic pupil size. Average keratometry and minimal pachymetry exhibited a statistically significant, but clinically insignificant, impact on mesopic pupil size.
评估可能影响屈光手术候选者中视瞳孔大小的因素。
回顾了13959名屈光手术候选者的13959只眼睛的病历，每个受试者随机选择一只眼睛进行统计分析。从病历中获取详细的眼科检查数据。术前测量包括未矫正远视力、矫正远视力、显验光和散瞳验光、地形图、裂隙灯检查和眼底检查。使用科尔瓦德瞳孔计进行中视瞳孔大小测量。通过方差分析（+协方差分析）和多元回归分析，分析中视瞳孔大小与年龄、性别、屈光状态、平均角膜曲率和角膜厚度（最薄点）之间的关系。
总体中视瞳孔大小为6.45±0.82毫米，平均年龄为36.07岁。远视散光患者的中视瞳孔大小为5.96±0.8毫米，高度散光患者为6.36±0.83毫米，近视散光患者为6.51±0.8毫米。所有屈光亚组之间的中视瞳孔大小差异具有统计学意义（p<0.001）。年龄与中视瞳孔大小的相关性最强（r=-0.405，p<0.001）。等效球镜度显示出中等相关性（r=-0.136），而角膜曲率（r=-0.064）和角膜厚度（r=-0.057）与中视瞳孔大小的相关性较弱。在性别和眼别方面，中视瞳孔大小没有统计学上的显著差异。所有分析因素（年龄、屈光状态、角膜曲率和角膜厚度）的总和只能预测不到20%的预期瞳孔大小（R=0.179，p<0.001）。
我们的分析证实，年龄和屈光状态是中视瞳孔大小的决定性因素。平均角膜曲率和最小角膜厚度对中视瞳孔大小有统计学上的显著影响，但临床意义不大。
