Effects of Femtosecond Laser-Assisted Cataract Pretreatment on Pupil Diameter: A Comparison Between Three Laser Platforms.

Abstract

PURPOSE:

To assess pupil diameter before and after femtosecond laser-assisted cataract surgery (FLACS) pretreatment and compare the outcomes of three laser platforms.

METHODS:

This prospective observational case series included consecutive patients scheduled to undergo cataract extraction using FLACS between August 2013 and February 2015. All eyes received FLACS pretreatment using three laser platforms: LenSx (Alcon Laboratories, Inc., Fort Worth, TX), Catalys (Abbott Medical Optics Inc., Santa Ana, CA), and Victus (Bausch & Lomb, Inc., Rochester, NY). The same protocol for preoperative medical mydriasis was used for all patients, and pupil diameter was assessed immediately before and 3 minutes after FLACS using a surgical ruler.

RESULTS:

A total of 198 eyes of 161 patients were included in the study. Mean pupillary miosis was 1.42 ± 1.26 mm for the LenSx, 0.66 ± 0.89 mm for the Catalys, and 0.14 ± 0.34 mm for the Victus groups. Furthermore, 8 of the 198 eyes (4.0%) demonstrated a pupil diameter of less than 5 mm after FLACS and 48 eyes (24.24%) demonstrated a pupil diameter of 6 mm or less. There was a statistically significant decrease in pupil diameter for all groups individually (P < .05). There was also a statistically significant difference among the three groups (P < .05), with LenSx inducing the highest degree of miosis, followed by Catalys, and finally Victus. A correlation between the pupil diameter before FLACS and degree of FLACS-induced miosis was demonstrated (P < .05), with larger pupil diameter before FLACS associated with greater miosis.

CONCLUSIONS:

FLACS pretreatment seems to induce significant pupillary miosis with all laser platforms assessed in this study. The decrease in pupil diameter after FLACS reached clinical significance for cataract extraction (< 5 mm) in 4.0% of cases, whereas 20.2% of eyes demonstrated small pupil diameter (≤ 6 mm) after FLACS pretreatment.

• Authors: Vasilios F Diakonis, Nilufer Yesilirmak, Ibrahim O Sayed-Ahmed, Daniel P Warren, George A Kounis, Zachary Davis, Florence Cabot, Sonia H Yoo, Terrence P O'Brien, Kendall E Donaldson
• Journal: Journal of refractive surgery (Thorofare, N.J. : 1995) (J Refract Surg) Vol. 32 Issue 2 Pg. 84-8 (Feb 2016) ISSN: 1081-597X [Print] United States
• PMID: 26856424 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright 2016, SLACK Incorporated.

Topics

• Adult
• Aged
• Aged, 80 and over
• Cataract Extraction (methods)
• Female
• Humans
• Iris (pathology)
• Laser Therapy (adverse effects, instrumentation)
• Male
• Middle Aged
• Miosis (diagnosis, etiology)
• Preoperative Period
• Prospective Studies
• Pupil