Small pupils show worsening glare symptoms at night after LASIK

Patients with different pupil sizes have no initial statistical difference after wavefront-guided LASIK, but by 12 months, patients with small pupils experienced worsening symptoms of glare at night.

Edward E. Manche, MD, PhD, presented the study at the European Society of Cataract and Refractive Surgeons meeting in Barcelona.

The study evaluated 102 eyes; 23 eyes were in the small pupil group (less than 5.5 mm), 37 eyes were in the medium pupil group (5.5 mm to 6 mm), and 42 eyes were in the large pupil group (larger than 6 mm).

"What we found was that all three groups experienced an increase in symptoms in the early postoperative period. ... At the final 12-month postoperative visit, patients with small pupils experienced more glare at night than medium or large pupils, but we did not find any correlation between large pupil size and any increase in postoperative visual symptoms," Dr. Manche said.

"[We also found] that small pupil size was positively and statistically correlated with an increase in glare symptoms and a decrease in clarity of vision at night. So this is somewhat counterintuitive — what many people would say is small pupils are at minimal risk or lower risk of developing symptoms postoperatively. So this was somewhat unexpected in our study," Dr. Manche said.