Regional EuroTimes
Date Posted 15/06/2009
Study highlights age-dependence of pupil size
Scotopic and mesopic pupil size is age-dependent, and this phenomenon should be taken into account in refractive surgery candidates, Ieva Sliesoraityte MD, told the 17th Congress of the European Society of Ophthalmology, (SOE).
Dr Sliesoraityte presented the findings of a prospective study conducted at Regensburg University Hospital, Germany. It included 318 eyes of 159 consecutive refractive surgery candidates with an age range from 18 to 58 years. The study excluded patients with a history of ocular injury, any ocular pathology, or using any medications that might influence pupil size.
Duplicate measurements of pupil size were obtained in all patients under standardised conditions at both scotopic and low mesopic illumination levels using a digital infrared pupillometer (Procyon P2000 SA pupillometer, Procyon Instruments). Age-dependence of pupil size was analysed by dividing the patients into four groups: ≤25 years, >25-35 years; >35-45 years, and >45 years.
Mean pupil size under scotopic and mesopic illumination was 6.82mm and 5.60mm, respectively. The difference between mesopic and scotopic pupil size was statistically significant. Pupil size did not differ by gender.
Analyses of mean pupil size by age group showed both scotopic and low mesopic pupil diameter decreased with increasing age and both in males and females. Further analysis showed scotopic pupil size decreased by 0.39mm for every 10 years of age while there was a 0.36mm decrease per 10 years increase of age for mesopic pupil size.
“Reliable pupil diameter measurements under different illumination levels are necessary in refractive surgery candidates. However, most refractive surgeons measure pupil size only once prior to surgery and ignore the fact that the size of the pupil is a dynamic and age-dependent variable,” noted Dr Sliesoraityte.
“When performing laser vision correction, the optical zone size should ideally exceed the pupil diameter under any level of ambient illumination in order to minimise risk of glare, haloes, ghost images, and blurred vision after refractive surgery. We believe the significant age-related decrease in pupil diameter under mesopic and scotopic conditions should be considered for refractive surgery candidates. Especially in young patients with high myopia, pupil size might limit a patient’s suitability for refractive surgery.
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