Mesopic pupil indices as potential risk factors for glare disability after intraocular implantable collamer lens implantation: prospective study

Abstract

Purpose: To explore the influence of preoperative factors, including varying pupil sizes and refractive attributes, on postoperative glare disability in patients undergoing implantable collamer lens (ICL) implantation.

Setting: Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China.

Design: Prospective observational study.

Methods: The preoperative ocular characteristics and 6-month postoperative glare status in eligible patients who underwent EVO-Visian ICL V4c (VICMO) implantation were analyzed. The glare disability criteria encompassed a glare symptom score >6 and glare sensitivity exceeding 1:2.7. Logistic regression analysis was used to explore the relationship between the preoperative ocular parameters and post-ICL glare.

Results: The study included 95 patients (mean age, 26.04 ± 6.29 years), comprising 30 men (58 eyes) and 65 women (129 eyes). Multivariate analysis revealed a significant correlation between postoperative glare disability and increased spherical power in preoperative mesopic pupils (β = -0.124, P = .039), as well as elevated cylinder power in preoperative mesopic (β = -0.412, P = .009) and photopic pupils (β = -0.430, P = .007). Moreover, a larger preoperative mesopic pupil diameter (β = 0.561, P = .005) demonstrated a significant correlation with glare disability.

Conclusions: Preoperative mesopic pupil dimensions and associated refractive parameters, such as sphere and cylinder, were correlated with glare disability, including the cylinder aspect in photopic pupils, which can assist clinicians in optimizing preoperative selection for ICL implantation, aiding in the anticipation of potential glare disability risks.

Trial registration: ClinicalTrials.gov NCT05658718.