Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device

Parth Satani; Shabnam Tanwar; Suhas Haldipurkar; Vijay Shetty; Devendra Venkatramani; Maninder Singh Setia

doi:doi:10.11648/j.ijovs.20220703.12

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Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device

Parth Satani, Shabnam Tanwar, Suhas Haldipurkar, Vijay Shetty, Devendra Venkatramani, Maninder Singh Setia

Published in International Journal of Ophthalmology & Visual Science (Volume 7, Issue 3)

Received: 24 July 2022 Accepted: 15 August 2022 Published: 24 August 2022

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Abstract

Background: It may be challenging to perform phacoemulsification in cataract patients who have small or poorly dilated pupils. Objective: We conducted this cross-sectional analysis of secondary data to compare the visual outcomes, contrast sensitivity, and higher order aberrations in eyes in with and without the use of pupil dilating technique during phacoemulsification. Methods: We compared the best corrected distance visual acuity (BCDVA), pupil size and contrast sensitivity (photopic and scotopic conditions), higher order aberrations, and satisfaction in 20 eyes (18 patients) in whom no pupil dilating device was used (Group A) with 19 eyes (17 patients) in the ‘Pupil dilating device group’ (Group B). In small pupil patients, the surgeon used one of the pupil dilating technique (stretch pupilloplasty, iris-hook, or malyugin rings) for intra-operative pupil dilatation. Results: In the post-operative examination, the median (IQR) logMAR values for BCDVA was significantly lower in Group A compared with Group B (0.00 [0.00, 0.09] vs. 0.18 [0.00, 0.18], p = 0.03). However, there were no significant differences in the near vision. The mean change in pupil size was significantly more in Group A compared with Group B (0.85 [0.46] vs 0.53 [0.31]; p = 0.01). After adjusting for age, gender, and time since surgery, mean contrast sensitivity (photopic) was significantly lower in whom Iris Hooks were used compared with those in whom pupil dilating device was used (-0.270, 95% confidence intervals [CI]: -0.464, -0.076, p < 0.001). The satisfaction with vision was very high (97%). Conclusion: Pupil dilating devices are often used in small pupils. However, visual acuity and pupillary reaction may be reduced post-operatively in these patients. Thus, they should be adequately counselled about these potential side effects during the pre-surgical period.

Published in	International Journal of Ophthalmology & Visual Science (Volume 7, Issue 3)
DOI	10.11648/j.ijovs.20220703.12
Page(s)	95-100
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Pupil Dilating Devices, Visual Outcomes, Higher Order Aberrations, Contrast Sensitivity, Phacoemulsification

References

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APA Style

Parth Satani, Shabnam Tanwar, Suhas Haldipurkar, Vijay Shetty, Devendra Venkatramani, et al. (2022). Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. International Journal of Ophthalmology & Visual Science, 7(3), 95-100. https://doi.org/10.11648/j.ijovs.20220703.12

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ACS Style

Parth Satani; Shabnam Tanwar; Suhas Haldipurkar; Vijay Shetty; Devendra Venkatramani, et al. Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. Int. J. Ophthalmol. Vis. Sci. 2022, 7(3), 95-100. doi: 10.11648/j.ijovs.20220703.12

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AMA Style

Parth Satani, Shabnam Tanwar, Suhas Haldipurkar, Vijay Shetty, Devendra Venkatramani, et al. Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. Int J Ophthalmol Vis Sci. 2022;7(3):95-100. doi: 10.11648/j.ijovs.20220703.12

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@article{10.11648/j.ijovs.20220703.12,
  author = {Parth Satani and Shabnam Tanwar and Suhas Haldipurkar and Vijay Shetty and Devendra Venkatramani and Maninder Singh Setia},
  title = {Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {7},
  number = {3},
  pages = {95-100},
  doi = {10.11648/j.ijovs.20220703.12},
  url = {https://doi.org/10.11648/j.ijovs.20220703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20220703.12},
  abstract = {Background: It may be challenging to perform phacoemulsification in cataract patients who have small or poorly dilated pupils. Objective: We conducted this cross-sectional analysis of secondary data to compare the visual outcomes, contrast sensitivity, and higher order aberrations in eyes in with and without the use of pupil dilating technique during phacoemulsification. Methods: We compared the best corrected distance visual acuity (BCDVA), pupil size and contrast sensitivity (photopic and scotopic conditions), higher order aberrations, and satisfaction in 20 eyes (18 patients) in whom no pupil dilating device was used (Group A) with 19 eyes (17 patients) in the ‘Pupil dilating device group’ (Group B). In small pupil patients, the surgeon used one of the pupil dilating technique (stretch pupilloplasty, iris-hook, or malyugin rings) for intra-operative pupil dilatation. Results: In the post-operative examination, the median (IQR) logMAR values for BCDVA was significantly lower in Group A compared with Group B (0.00 [0.00, 0.09] vs. 0.18 [0.00, 0.18], p = 0.03). However, there were no significant differences in the near vision. The mean change in pupil size was significantly more in Group A compared with Group B (0.85 [0.46] vs 0.53 [0.31]; p = 0.01). After adjusting for age, gender, and time since surgery, mean contrast sensitivity (photopic) was significantly lower in whom Iris Hooks were used compared with those in whom pupil dilating device was used (-0.270, 95% confidence intervals [CI]: -0.464, -0.076, p < 0.001). The satisfaction with vision was very high (97%). Conclusion: Pupil dilating devices are often used in small pupils. However, visual acuity and pupillary reaction may be reduced post-operatively in these patients. Thus, they should be adequately counselled about these potential side effects during the pre-surgical period.},
 year = {2022}
}

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TY  - JOUR
T1  - Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device
AU  - Parth Satani
AU  - Shabnam Tanwar
AU  - Suhas Haldipurkar
AU  - Vijay Shetty
AU  - Devendra Venkatramani
AU  - Maninder Singh Setia
Y1  - 2022/08/24
PY  - 2022
N1  - https://doi.org/10.11648/j.ijovs.20220703.12
DO  - 10.11648/j.ijovs.20220703.12
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 95
EP  - 100
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20220703.12
AB  - Background: It may be challenging to perform phacoemulsification in cataract patients who have small or poorly dilated pupils. Objective: We conducted this cross-sectional analysis of secondary data to compare the visual outcomes, contrast sensitivity, and higher order aberrations in eyes in with and without the use of pupil dilating technique during phacoemulsification. Methods: We compared the best corrected distance visual acuity (BCDVA), pupil size and contrast sensitivity (photopic and scotopic conditions), higher order aberrations, and satisfaction in 20 eyes (18 patients) in whom no pupil dilating device was used (Group A) with 19 eyes (17 patients) in the ‘Pupil dilating device group’ (Group B). In small pupil patients, the surgeon used one of the pupil dilating technique (stretch pupilloplasty, iris-hook, or malyugin rings) for intra-operative pupil dilatation. Results: In the post-operative examination, the median (IQR) logMAR values for BCDVA was significantly lower in Group A compared with Group B (0.00 [0.00, 0.09] vs. 0.18 [0.00, 0.18], p = 0.03). However, there were no significant differences in the near vision. The mean change in pupil size was significantly more in Group A compared with Group B (0.85 [0.46] vs 0.53 [0.31]; p = 0.01). After adjusting for age, gender, and time since surgery, mean contrast sensitivity (photopic) was significantly lower in whom Iris Hooks were used compared with those in whom pupil dilating device was used (-0.270, 95% confidence intervals [CI]: -0.464, -0.076, p < 0.001). The satisfaction with vision was very high (97%). Conclusion: Pupil dilating devices are often used in small pupils. However, visual acuity and pupillary reaction may be reduced post-operatively in these patients. Thus, they should be adequately counselled about these potential side effects during the pre-surgical period.
VL  - 7
IS  - 3
ER  -

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Author Information

Parth Satani

Department of Ophthalmology, Laxmi Eye Institute, Panvel, India
Shabnam Tanwar

Department of Ophthalmology, Laxmi Eye Institute, Panvel, India
Suhas Haldipurkar

Department of Ophthalmology, Laxmi Eye Institute, Panvel, India
Vijay Shetty

Department of Ophthalmology, Laxmi Eye Institute, Panvel, India
Devendra Venkatramani

Department of Ophthalmology, Laxmi Eye Institute, Panvel, India
Maninder Singh Setia

Department of Ophthalmology, Laxmi Eye Institute, Panvel, India

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APA Style

Parth Satani, Shabnam Tanwar, Suhas Haldipurkar, Vijay Shetty, Devendra Venkatramani, et al. (2022). Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. International Journal of Ophthalmology & Visual Science, 7(3), 95-100. https://doi.org/10.11648/j.ijovs.20220703.12

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ACS Style

Parth Satani; Shabnam Tanwar; Suhas Haldipurkar; Vijay Shetty; Devendra Venkatramani, et al. Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. Int. J. Ophthalmol. Vis. Sci. 2022, 7(3), 95-100. doi: 10.11648/j.ijovs.20220703.12

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AMA Style

Parth Satani, Shabnam Tanwar, Suhas Haldipurkar, Vijay Shetty, Devendra Venkatramani, et al. Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device. Int J Ophthalmol Vis Sci. 2022;7(3):95-100. doi: 10.11648/j.ijovs.20220703.12

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@article{10.11648/j.ijovs.20220703.12,
  author = {Parth Satani and Shabnam Tanwar and Suhas Haldipurkar and Vijay Shetty and Devendra Venkatramani and Maninder Singh Setia},
  title = {Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {7},
  number = {3},
  pages = {95-100},
  doi = {10.11648/j.ijovs.20220703.12},
  url = {https://doi.org/10.11648/j.ijovs.20220703.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20220703.12},
  abstract = {Background: It may be challenging to perform phacoemulsification in cataract patients who have small or poorly dilated pupils. Objective: We conducted this cross-sectional analysis of secondary data to compare the visual outcomes, contrast sensitivity, and higher order aberrations in eyes in with and without the use of pupil dilating technique during phacoemulsification. Methods: We compared the best corrected distance visual acuity (BCDVA), pupil size and contrast sensitivity (photopic and scotopic conditions), higher order aberrations, and satisfaction in 20 eyes (18 patients) in whom no pupil dilating device was used (Group A) with 19 eyes (17 patients) in the ‘Pupil dilating device group’ (Group B). In small pupil patients, the surgeon used one of the pupil dilating technique (stretch pupilloplasty, iris-hook, or malyugin rings) for intra-operative pupil dilatation. Results: In the post-operative examination, the median (IQR) logMAR values for BCDVA was significantly lower in Group A compared with Group B (0.00 [0.00, 0.09] vs. 0.18 [0.00, 0.18], p = 0.03). However, there were no significant differences in the near vision. The mean change in pupil size was significantly more in Group A compared with Group B (0.85 [0.46] vs 0.53 [0.31]; p = 0.01). After adjusting for age, gender, and time since surgery, mean contrast sensitivity (photopic) was significantly lower in whom Iris Hooks were used compared with those in whom pupil dilating device was used (-0.270, 95% confidence intervals [CI]: -0.464, -0.076, p < 0.001). The satisfaction with vision was very high (97%). Conclusion: Pupil dilating devices are often used in small pupils. However, visual acuity and pupillary reaction may be reduced post-operatively in these patients. Thus, they should be adequately counselled about these potential side effects during the pre-surgical period.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Comparison of Visual Outcome in Phacoemulsification Surgery with and Without Intra-Operative Use of Pupil Dilating Device
AU  - Parth Satani
AU  - Shabnam Tanwar
AU  - Suhas Haldipurkar
AU  - Vijay Shetty
AU  - Devendra Venkatramani
AU  - Maninder Singh Setia
Y1  - 2022/08/24
PY  - 2022
N1  - https://doi.org/10.11648/j.ijovs.20220703.12
DO  - 10.11648/j.ijovs.20220703.12
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 95
EP  - 100
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20220703.12
AB  - Background: It may be challenging to perform phacoemulsification in cataract patients who have small or poorly dilated pupils. Objective: We conducted this cross-sectional analysis of secondary data to compare the visual outcomes, contrast sensitivity, and higher order aberrations in eyes in with and without the use of pupil dilating technique during phacoemulsification. Methods: We compared the best corrected distance visual acuity (BCDVA), pupil size and contrast sensitivity (photopic and scotopic conditions), higher order aberrations, and satisfaction in 20 eyes (18 patients) in whom no pupil dilating device was used (Group A) with 19 eyes (17 patients) in the ‘Pupil dilating device group’ (Group B). In small pupil patients, the surgeon used one of the pupil dilating technique (stretch pupilloplasty, iris-hook, or malyugin rings) for intra-operative pupil dilatation. Results: In the post-operative examination, the median (IQR) logMAR values for BCDVA was significantly lower in Group A compared with Group B (0.00 [0.00, 0.09] vs. 0.18 [0.00, 0.18], p = 0.03). However, there were no significant differences in the near vision. The mean change in pupil size was significantly more in Group A compared with Group B (0.85 [0.46] vs 0.53 [0.31]; p = 0.01). After adjusting for age, gender, and time since surgery, mean contrast sensitivity (photopic) was significantly lower in whom Iris Hooks were used compared with those in whom pupil dilating device was used (-0.270, 95% confidence intervals [CI]: -0.464, -0.076, p < 0.001). The satisfaction with vision was very high (97%). Conclusion: Pupil dilating devices are often used in small pupils. However, visual acuity and pupillary reaction may be reduced post-operatively in these patients. Thus, they should be adequately counselled about these potential side effects during the pre-surgical period.
VL  - 7
IS  - 3
ER  -

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