瞳孔大小对同时视人工晶状体功能结果的影响。
Effects of Pupil Size on Functional Outcomes of a Simultaneous Vision Intraocular Lens.
作者信息
Davidova Petra, Kaiser Klemens P, Hemkeppler Eva, Böhm Myriam, Kohnen Thomas
出版信息
J Refract Surg. 2025 Jul;41(7):e645-e654. doi: 10.3928/1081597X-20250515-02. Epub 2025 Jul 1.
PURPOSE
To evaluate the relationship between pupil size and subjective visual quality after implantation of a simultaneous vision intraocular lens (IOL).
METHODS
Patients after bilateral implantation of a trifocal, diffractive IOL were prospectively included. Three months postoperatively, subjective refraction, UDVA, and axis deviation were measured. Pupil size was obtained with an infrared-based pupillometer (PupilX; Albomed) in scotopic, mesopic, and photopic conditions. Subjective impairment with optical phenomena was surveyed in different lighting conditions.
RESULTS
Fifty-two patients (mean age: 68 years) were included; 54 eyes received non-toric IOLs and 50 eyes received toric IOLs. Preoperative spherical equivalent (SE) was -0.914 diopters (D) (range: -10.00 to +5.92 D) and SE and lens torus were 20.3 D (range: 9.00 to 32.00 D) and 1.65 D (range: 1.00 to 3.75 D), respectively. Three months postoperatively pupil size was 5.42 mm (range: 2.60 to 7.50 mm) in scotopic, 4.24 mm (range: 2.60 to 6.10 mm) in mesopic, and 3.38 mm (range: 1.20 to 5.60 mm) in photopic conditions, spherical manifest refractive error 0.14 D (range: -0.75 to 1.25 D), SE 0.034 D (range: -1.13 to +1.13 D), and UDVA 20/22.4 (range: 20/63 to 20/12.5). In low light conditions, halos correlated weakly with scotopic (r = 0.268, = .006) and mesopic ( = 0.298, = .002) pupil size and double-contour with scotopic pupil size ( = 0.234, = .018). Glare, starbursts, and blurred vision were not influenced in any condition. Further significant influential factors were postoperative spherical manifest refractive error ( = .014), SE ( = .007) and lens torus ( = .029) for halos and preoperative SE ( = .019), postoperative UDVA ( = .035), and lens SE ( = .023) for double-contour. In multiple regression analysis, lens torus, mesopic pupil size, preoperative SE, and postoperative UDVA remained significant.
CONCLUSIONS
Pupil size did not play a major role in disturbance with optical phenomena after implantation of a trifocal diffractive IOL. .
目的
评估植入同步视觉人工晶状体（IOL）后瞳孔大小与主观视觉质量之间的关系。
方法
前瞻性纳入双侧植入三焦点衍射IOL的患者。术后三个月，测量主观验光、最佳矫正远视力（UDVA）和轴位偏差。使用基于红外线的瞳孔计（PupilX；Albomed）在暗视、中间视觉和明视条件下测量瞳孔大小。在不同光照条件下调查光学现象引起的主观不适。
结果
纳入52例患者（平均年龄：68岁）；54只眼植入非散光IOL，50只眼植入散光IOL。术前等效球镜度（SE）为-0.914屈光度（D）（范围：-10.00至+5.92 D），SE和晶状体散光分别为20.3 D（范围：9.00至32.00 D）和1.65 D（范围：1.00至3.75 D）。术后三个月，暗视条件下瞳孔大小为5.42 mm（范围：2.60至7.50 mm），中间视觉条件下为4.24 mm（范围：2.60至6.10 mm），明视条件下为3.38 mm（范围：1.20至5.60 mm），球镜显性屈光不正为0.14 D（范围：-0.75至1.25 D），SE为0.034 D（范围：-1.13至+1.13 D），UDVA为20/22.4（范围：20/63至20/12.5）。在低光条件下，光晕与暗视（r = 0.268，P = .006）和中间视觉（P = 0.298，P = .002）瞳孔大小弱相关，双轮廓与暗视瞳孔大小相关（P = 0.234，P = .018）。在任何条件下，眩光、星芒和视力模糊均未受影响。对于光晕，其他显著影响因素为术后球镜显性屈光不正（P = .014）、SE（P = .007）和晶状体散光（P = .029）；对于双轮廓，为术前SE（P = .019）、术后UDVA（P = .035）和晶状体SE（P = .023）。在多元回归分析中，晶状体散光、中间视觉瞳孔大小、术前SE和术后UDVA仍然显著。
结论
在植入三焦点衍射IOL后，瞳孔大小在光学现象干扰中未起主要作用。
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