Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan.
Jpn J Ophthalmol. 2021 Sep;65(5):616-623. doi: 10.1007/s10384-021-00837-5. Epub 2021 May 11.
To examine the changes in the pupillary light response after phacoemulsification and to compare the difference in the response among patients in different age categories.
Prospective observational study.
Four-hundred twenty-two eyes of 422 patients in 3 age categories (60-69 years, 70-79 years, and 80-89 years) scheduled for phacoemulsification were consecutively enrolled. The eyes underwent examinations with an infrared pupillometer to obtain the parameters of the pupillary light response preoperatively and at 1 day and 1 and 3 months postoperatively. Differences in the parameters of the pupillary response were compared among 4 time intervals and the 3 age categories.
The mean maximum and minimum pupillary diameters significantly decreased at 1 day postoperatively and returned to the preoperative level by 1 month postoperatively (P<.0001). The mean percentage of pupillary constriction was significantly reduced at 1 and 3 months postoperatively compared with preoperatively and at 1 day postoperatively (P<.0001). The average pupillary constriction and dilation velocities were significantly lower at 1 and 3 months postoperatively than they were preoperatively and at 1 day postoperatively (P<.0001). The latency to constriction did not differ significantly among the time intervals. The percentage of pupillary constriction was significantly smaller, and the average constriction and dilation velocities were lower in association with higher age categories at all time intervals (P≤.0185).
The pupillary light response was impaired several months after cataract surgery and worsened with increasing patient age, indicating that cataract surgery may compromise the pupillary constriction and dilation functions in association with age.
观察白内障超声乳化术后瞳孔光反应的变化,并比较不同年龄段患者的反应差异。
前瞻性观察研究。
连续纳入 3 个年龄组(60-69 岁、70-79 岁和 80-89 岁)的 422 例 422 只眼拟行白内障超声乳化术的患者。采用红外瞳孔计对这些患者进行术前及术后 1 天、1 个月和 3 个月的瞳孔光反应检查,获得瞳孔光反应的各项参数。比较 4 个时间点和 3 个年龄组之间瞳孔反应参数的差异。
最大和最小瞳孔直径的平均值在术后 1 天显著减小,术后 1 个月恢复至术前水平(P<.0001)。与术前和术后 1 天相比,术后 1 个月和 3 个月的瞳孔收缩率平均值显著降低(P<.0001)。与术前和术后 1 天相比,术后 1 个月和 3 个月的瞳孔收缩和扩张速度的平均值显著降低(P<.0001)。术后 1 天和 3 个月的瞳孔收缩潜伏期与其他时间点无显著差异。在所有时间点,瞳孔收缩率均随年龄的增加而显著降低,平均瞳孔收缩和扩张速度也随之降低(P≤.0185)。
白内障手术后数月,瞳孔光反应受损,且随患者年龄的增加而恶化,表明白内障手术可能会影响瞳孔的收缩和扩张功能,这种影响与年龄有关。