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Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device

Received: 24 July 2022     Accepted: 15 August 2022     Published: 24 August 2022
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Abstract

Background: It may be challenging to perform phacoemulsification in cataract patients who have small or poorly dilated pupils. Objective: We conducted this cross-sectional analysis of secondary data to compare the visual outcomes, contrast sensitivity, and higher order aberrations in eyes in with and without the use of pupil dilating technique during phacoemulsification. Methods: We compared the best corrected distance visual acuity (BCDVA), pupil size and contrast sensitivity (photopic and scotopic conditions), higher order aberrations, and satisfaction in 20 eyes (18 patients) in whom no pupil dilating device was used (Group A) with 19 eyes (17 patients) in the ‘Pupil dilating device group’ (Group B). In small pupil patients, the surgeon used one of the pupil dilating technique (stretch pupilloplasty, iris-hook, or malyugin rings) for intra-operative pupil dilatation. Results: In the post-operative examination, the median (IQR) logMAR values for BCDVA was significantly lower in Group A compared with Group B (0.00 [0.00, 0.09] vs. 0.18 [0.00, 0.18], p = 0.03). However, there were no significant differences in the near vision. The mean change in pupil size was significantly more in Group A compared with Group B (0.85 [0.46] vs 0.53 [0.31]; p = 0.01). After adjusting for age, gender, and time since surgery, mean contrast sensitivity (photopic) was significantly lower in whom Iris Hooks were used compared with those in whom pupil dilating device was used (-0.270, 95% confidence intervals [CI]: -0.464, -0.076, p < 0.001). The satisfaction with vision was very high (97%). Conclusion: Pupil dilating devices are often used in small pupils. However, visual acuity and pupillary reaction may be reduced post-operatively in these patients. Thus, they should be adequately counselled about these potential side effects during the pre-surgical period.

Published in International Journal of Ophthalmology & Visual Science (Volume 7, Issue 3)
DOI 10.11648/j.ijovs.20220703.12
Page(s) 95-100
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Pupil Dilating Devices, Visual Outcomes, Higher Order Aberrations, Contrast Sensitivity, Phacoemulsification

References
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    Parth Satani, Shabnam Tanwar, Suhas Haldipurkar, Vijay Shetty, Devendra Venkatramani, et al. (2022). Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. International Journal of Ophthalmology & Visual Science, 7(3), 95-100. https://doi.org/10.11648/j.ijovs.20220703.12

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    ACS Style

    Parth Satani; Shabnam Tanwar; Suhas Haldipurkar; Vijay Shetty; Devendra Venkatramani, et al. Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. Int. J. Ophthalmol. Vis. Sci. 2022, 7(3), 95-100. doi: 10.11648/j.ijovs.20220703.12

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    AMA Style

    Parth Satani, Shabnam Tanwar, Suhas Haldipurkar, Vijay Shetty, Devendra Venkatramani, et al. Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. Int J Ophthalmol Vis Sci. 2022;7(3):95-100. doi: 10.11648/j.ijovs.20220703.12

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  • @article{10.11648/j.ijovs.20220703.12,
      author = {Parth Satani and Shabnam Tanwar and Suhas Haldipurkar and Vijay Shetty and Devendra Venkatramani and Maninder Singh Setia},
      title = {Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device},
      journal = {International Journal of Ophthalmology & Visual Science},
      volume = {7},
      number = {3},
      pages = {95-100},
      doi = {10.11648/j.ijovs.20220703.12},
      url = {https://doi.org/10.11648/j.ijovs.20220703.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20220703.12},
      abstract = {Background: It may be challenging to perform phacoemulsification in cataract patients who have small or poorly dilated pupils. Objective: We conducted this cross-sectional analysis of secondary data to compare the visual outcomes, contrast sensitivity, and higher order aberrations in eyes in with and without the use of pupil dilating technique during phacoemulsification. Methods: We compared the best corrected distance visual acuity (BCDVA), pupil size and contrast sensitivity (photopic and scotopic conditions), higher order aberrations, and satisfaction in 20 eyes (18 patients) in whom no pupil dilating device was used (Group A) with 19 eyes (17 patients) in the ‘Pupil dilating device group’ (Group B). In small pupil patients, the surgeon used one of the pupil dilating technique (stretch pupilloplasty, iris-hook, or malyugin rings) for intra-operative pupil dilatation. Results: In the post-operative examination, the median (IQR) logMAR values for BCDVA was significantly lower in Group A compared with Group B (0.00 [0.00, 0.09] vs. 0.18 [0.00, 0.18], p = 0.03). However, there were no significant differences in the near vision. The mean change in pupil size was significantly more in Group A compared with Group B (0.85 [0.46] vs 0.53 [0.31]; p = 0.01). After adjusting for age, gender, and time since surgery, mean contrast sensitivity (photopic) was significantly lower in whom Iris Hooks were used compared with those in whom pupil dilating device was used (-0.270, 95% confidence intervals [CI]: -0.464, -0.076, p < 0.001). The satisfaction with vision was very high (97%). Conclusion: Pupil dilating devices are often used in small pupils. However, visual acuity and pupillary reaction may be reduced post-operatively in these patients. Thus, they should be adequately counselled about these potential side effects during the pre-surgical period.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device
    AU  - Parth Satani
    AU  - Shabnam Tanwar
    AU  - Suhas Haldipurkar
    AU  - Vijay Shetty
    AU  - Devendra Venkatramani
    AU  - Maninder Singh Setia
    Y1  - 2022/08/24
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijovs.20220703.12
    DO  - 10.11648/j.ijovs.20220703.12
    T2  - International Journal of Ophthalmology & Visual Science
    JF  - International Journal of Ophthalmology & Visual Science
    JO  - International Journal of Ophthalmology & Visual Science
    SP  - 95
    EP  - 100
    PB  - Science Publishing Group
    SN  - 2637-3858
    UR  - https://doi.org/10.11648/j.ijovs.20220703.12
    AB  - Background: It may be challenging to perform phacoemulsification in cataract patients who have small or poorly dilated pupils. Objective: We conducted this cross-sectional analysis of secondary data to compare the visual outcomes, contrast sensitivity, and higher order aberrations in eyes in with and without the use of pupil dilating technique during phacoemulsification. Methods: We compared the best corrected distance visual acuity (BCDVA), pupil size and contrast sensitivity (photopic and scotopic conditions), higher order aberrations, and satisfaction in 20 eyes (18 patients) in whom no pupil dilating device was used (Group A) with 19 eyes (17 patients) in the ‘Pupil dilating device group’ (Group B). In small pupil patients, the surgeon used one of the pupil dilating technique (stretch pupilloplasty, iris-hook, or malyugin rings) for intra-operative pupil dilatation. Results: In the post-operative examination, the median (IQR) logMAR values for BCDVA was significantly lower in Group A compared with Group B (0.00 [0.00, 0.09] vs. 0.18 [0.00, 0.18], p = 0.03). However, there were no significant differences in the near vision. The mean change in pupil size was significantly more in Group A compared with Group B (0.85 [0.46] vs 0.53 [0.31]; p = 0.01). After adjusting for age, gender, and time since surgery, mean contrast sensitivity (photopic) was significantly lower in whom Iris Hooks were used compared with those in whom pupil dilating device was used (-0.270, 95% confidence intervals [CI]: -0.464, -0.076, p < 0.001). The satisfaction with vision was very high (97%). Conclusion: Pupil dilating devices are often used in small pupils. However, visual acuity and pupillary reaction may be reduced post-operatively in these patients. Thus, they should be adequately counselled about these potential side effects during the pre-surgical period.
    VL  - 7
    IS  - 3
    ER  - 

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Author Information
  • Department of Ophthalmology, Laxmi Eye Institute, Panvel, India

  • Department of Ophthalmology, Laxmi Eye Institute, Panvel, India

  • Department of Ophthalmology, Laxmi Eye Institute, Panvel, India

  • Department of Ophthalmology, Laxmi Eye Institute, Panvel, India

  • Department of Ophthalmology, Laxmi Eye Institute, Panvel, India

  • Department of Ophthalmology, Laxmi Eye Institute, Panvel, India

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