1 Department of Ophthalmology, Liuzhou Workers’ Hospital, Liuzhou 545005, China; 2 Department of Ophthalmology, Shandong Provincial Hospital, Jinan 250000, China
Abstract：Objective: To evaluate the effect of pupil parameters on quality of vision after laser refractive surgery for presbyopia. Methods: In this prospective study, 60 consecutive presbyopic patients (120 eyes) with moderate myopia were included from January to December 2020 at Liuzhou Workers’ Hospital. Subjects were divided into three groups according to pupil size at an intermediate visual environment (1 cd/m2): small pupil group (SPG) ( 5.5 mm), medium pupil group (MPG) (5.6–6.4 mm), and large pupil group(LPG) ( 6.5 mm). The uncorrected visual acuity (UCVA), near vision (UCNVA), pupil parameters and aberrations were examined and compared before surgery, and at 1, 3, and 6 months after surgery. Repeated measurement analysis of variance was used to compare the changes in pupil parameters, visual acuity and aberration differences at different time points before and after surgery. ANOVA analysis of variance was used to compare the pupil parameters among the different groups before surgery. Results: The UCVA of the MPG and SPG groups was higher than that of the LPG group at 3 and 6 months after surgery (3 months after surgery: F=10.62, P<0.001; F=14.21, P<0.001; 6 months after surgery: F=14.88, P<0.001; F=14.81, P<0.001). The UCNVA of the SPG and MPG groups was better than that of the LPG group (3 months after surgery: F=37.62, P<0.001; F=25.62, P<0.001; 6 months after surgery: F=37.60, P<0.001; F=38.11, P<0.001). In the 6-month follow-up, patient satisfaction in the MGP group was higher than that in the LPG and SPG groups. At 1, 3 and 6 months after surgery, the amplitude, velocity, and duration of contraction in the MPG and SPG groups were better than those in the LPG group, and the differences were statistically significant (P<0.001). The latency of pupil dilation in the MPG and SPG groups was better than that in the LPG group (P<0.05). There was no significant difference in duration or velocity of dilation among the three groups. The values of the vertical coma (C7), horizontal coma (C8) and spherical aberrations (C12) all increased in the three groups, and most significantly in the LPG group (P<0.001). Conclusions: Six months after laser refractive surgery for presbyopia, patients with medium and small pupil size can have better visual quality.
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