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Dynamic Binocular Pupillometry: A New Method in Refractive Surgery
1Schmitz S., 1Henn S., 2Krummenauer F., 1Dick H. B.,
1Johannes-Gutenberg-Universität Mainz, Universitäts-Augenklinik (Mainz)
2Johannes-Gutenberg-Universität Mainz, Koordinierungszentrum für Klinische Studien (KKS) (Mainz)
Purpose: Pupil diameter plays an important role in the occurence of photopic phenomena after refractive surgery. One of the standardised measuring methods is the Colvard-Pupillometer where the pupil diameter is estimated with an inbuilt scale. The new Procyon P2000SA allows by use of infrared light the dynamic and binocular measurement of pupil diameter. Another method is the wavefront based measurement with the WASCA-Analyzer. These three methods were compared in a prospective controlled clinical trial.
Methods: With these device the pupil size of 56 eyes of 28 probationers (18 female, 10 male, age 23±3 years) were measured under scotopic conditions by three independent examiners. The measurement sceme was repeated three times. For intraindividual comparison of the measurement devices the mean pupil diameter was compared pairwise by the nonparametric sign test. The measurement instruments were compared in terms of the standard deviations of the observed values by pairwise Malony/Rastogi tests. Instrumental reliability was determined by the reliability coefficient according to Fleiss. Examiner-dependent effects were analysed with Friedman tests.
Results: Mean pupil diameter of 6.6mm were measured by Colvard- and the Procyon-Pupillometer, 6.3mm by the WASCA-Analyzer. Variances of the measured pupil diameters showed the biggest deviations for the Colvard device and the smallest for the Procyon-Pupillometer. All three devices showed sufficiently high overall reliability: Colvard 97%, Procyon 99% and WASCA 98%. For all three examiners no statistical significant differences were found.
Conclusions: Exact measurement of the pupil size is necessary to reduce night vision disturbances after LASIK. All three devices showed high reliability in measuring the pupil size. The Procyon-Pupillometer offers binocular pupillodynamics and offers some advantages over traditional methods.