Pupillary Diameter Change and Dynamics in Different Refractive Error Groups after Implantation of a Collamer Lens with a Central Hole Without Viscoelastic Agent

Background: To investigate the pupillary diameter and dynamics in different refractive error groups after non-viscoelastic agent-assisted implantation of a collamer lens with a central hole, so as to evaluate the effect on the pupil of this type of surgery. Methods: Consecutive patients with a range of refractive errors who underwent non-viscoelastic agent-assisted implantation of a collamer lens with a central hole (ICL V4c) were analyzed. OPD-Scan III (NIDEK Japan)was used to measure the pupillary diameter preoperatively and 1 month postoperatively. Pupillary dynamics were assessed by calculating the scotopic pupillary diameter minus the photopic pupillary diameter. All variables were measured under photopic and scotopic conditions. Results: In 53 patients (medium-low myopia group 44 eyes, 23 patients, age 33.3±1.2 years and high myopia group 60 eyes, 30 patients, age 31.7±1.5 years), the postoperative photopic pupil was significantly smaller than preoperatively in both groups, and the postoperative pupillary size was significantly larger in the high myopia group under both the photopic and scotopic conditions. Besides, the high myopia group had a significantly larger photopic-scotopic change postoperatively and greater change in the pupillary dynamics. Conclusion: Implantation of a collamer lens with a central hole without viscoelastic agent assistance affected the pupillary diameter and dynamics at 1 month postoperatively in the medium-low and high myopia groups. The group with medium and low diopters had stronger changes in pupil diameter after surgery, while the group with high diopters was more likely to be affected by changes in visual quality.