Impact of pupil size upon the quality of vision in patients implanted with an implantable collamer lens (ICL V4c): A pilot study

Abstract

Abstract Objective: This study aimed to assess the influence of pupil size on subjective visual quality in subjects with implanted collamer lenses (ICLs). Methods: This retrospective study assessed eyes implanted with ICL (V4c) and categorized them into incremental groups according to pupil size. Preoperative and postoperative photopic and mesopic pupil size, uncorrected distance visual acuity (UDVA), and quality of vision (QoV) questionnaire score were assessed and compared. Results: Post-operatively at 3-months the mean QoV score for day and night was 9.34 ± 0.76 and 8.58 ± 1.29 respectively. The mean mesopic pupil size (MPS) and mean photopic pupil size (PPS) was 6.59 ± 0.79 mm and 4.61 ± 0.74 mm respectively. PPS negatively correlated with “QoV day” (Rs = -0.413, P=0.001), positively correlated with “haloes” (Rs = 0.568*, P<0.001) and "blurred vision" (Rs = 0.243, P = 0.04) respectively. MPS negatively correlated with “QoV night” (Rs = -0.426, P=0.001), positively correlated with "haloes" (Rs = 0.624*, P < 0.001), "starburst" (Rs = 0.233, P=0.046) and "difficulty focusing" (Rs = 0.27, P = 0.025) respectively. Conclusion: The findings of this study suggest that increasing pupil size has a negative correlation on the subjective visual quality (QoV) for day and night scores. Smaller pupil size had better QoV night scores suggesting further investigation is needed.