J Refract Surg. 2013 Nov;29(11):734-41. doi: 10.3928/1081597X-20131021-02.
To provide a literature review on the evidence both for and against pupil size as an independent predictor of adverse visual outcomes after LASIK.
Peer-reviewed publications on the effect of pupil size on LASIK outcomes since 2002 are reviewed. Particular attention was paid to the following attributes of each publication: type of study, number of patients or eyes, mean age, mean level of myopia, mean pupil size, testing conditions, ablation zone diameter, presence or absence of blend zones, and mean follow-up period.
Among the 19 studies examined, none correlates a persistent relationship between pupil size and night vision complaints (NVCs) beyond 3 months when LASIK was performed with a 6.0-mm optical zone or larger ablation. The studies that did explicitly determine a correlation either included some or all patients with ablation zones smaller than 6.0 mm or did not specify ablation diameter at all. Among the studies that had drawn more mixed conclusions, the studies either covered short follow-up intervals (1 to 3 months) or showed a progressive improvement in NVCs over time in a relatively small patient cohort.
As keratorefractive technology continues to evolve, the role of pupil size warrants further investigation; however, based on the literature reviewed herein, modern LASIK has negated the role of the low light pupil in predicting adverse visual outcomes after LASIK outside of the early postoperative period.
对瞳孔大小作为 LASIK 术后不良视觉结果的独立预测因子的证据进行综述。
回顾了 2002 年以来关于瞳孔大小对 LASIK 结果影响的同行评议出版物。特别关注了每篇出版物的以下属性：研究类型、患者或眼睛数量、平均年龄、平均近视程度、平均瞳孔大小、测试条件、消融区直径、是否存在混合区以及平均随访期。
在所检查的 19 项研究中，当使用 6.0mm 光学区或更大的消融进行 LASIK 时，没有一项研究能将瞳孔大小与夜间视觉不适（NVC）之间的持续关系与 3 个月以上相关联。那些明确确定相关性的研究要么包括一些或所有消融区小于 6.0mm 的患者，要么根本没有指定消融直径。在得出更为混合结论的研究中，研究要么涵盖了较短的随访间隔（1 至 3 个月），要么在相对较小的患者队列中显示 NVC 随时间逐渐改善。
随着角膜屈光技术的不断发展，瞳孔大小的作用需要进一步研究；然而，根据本文综述的文献，现代 LASIK 已经否定了低光瞳孔在预测 LASIK 术后早期以外不良视觉结果的作用。
