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Pupillometry essential in premium IOL selection
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KOLOA, Hawaii — Surgeons should take pupil size into consideration according to the different premium IOL designs, a speaker said here.
"Pupillometry is often overlooked, but it is very important in IOL selection," Jeffrey D. Horn, MD, said in a presentation at Hawaiian Eye 2010. "This is especially important in premium IOLs."
"Surgeons must understand how the various IOLs function and how they are affected by pupil size," Dr. Horn said.
For example, with the ReSTOR apodized refractive-diffractive design (Alcon), light distribution changes with pupil size, so most light is directed for distance in large pupils but is split in small pupils, he said. With the Tecnis multifocal full optic diffractive design (Abbott Medical Optics), all light is diffracted regardless of pupil size.
Hawaiian Eye and Retina 2011 will be held January 16-21, 2011 at the Hyatt Regency Maui Resort & Spa in Ka'anapali, Maui. Learn more at OSNHawaiianEye.com.
Pupil size affects vision with any IOL, but even more so with multifocal lenses. With multifocal IOLs, which limit their diffractive rings to the central zone of the optic like the Alcon ReSTOR, reading vision is better with smaller pupils, while distance vision is better in dim lighting conditions, which may decrease night driving dysphotopsias. The AMO Tecnis multifocal IOL has diffractive rings through the entire optic, resulting in improved reading vision in low light situations when pupil sizes are larger. The key for the surgeon is to figure out which multifocal IOL is best for each individual patient, and this is dependent on pupil size, daily activities and patient desires.
– Uday Devgan, MD, FACS
OSN SuperSite
Section Editor