Changes in Pupil Area during Low-energy Femtosecond Laser-assisted Cataract Surgery

PURPOSE: To study the potential changes in pupil area within low-energy femtosecond-laser assisted cataract surgery (FLACS). METHODS: A retrospective assessment of the pupil size was performed in the eyes undergoing FLACS using the Ziemer LDV Z8. We measured the pupil diameters as part of the images taken preoperatively and at the completion of laser pretreatment (after releasing the suction). We calculated the pupil area in 40 eyes of 40 patients (14 right and 26 left eyes). The mean [Formula: see text] standard deviation (SD) of age of the patients was 74 [Formula: see text] 7.4 years (range: 51-87). Paired t-test was used for statistical analyses. Subgroups were built with reference to age and preoperative pupil area (smaller than or equal to the median versus larger than the median). RESULTS: The mean [Formula: see text] SD axial length, anterior chamber depth, white-to-white distance and lens thickness were 24.01 [Formula: see text] 1.47, 3.23 [Formula: see text] 0.4, 11.97 [Formula: see text] 0.49, and 4.59 [Formula: see text] 0.41 mm, respectively. The mean [Formula: see text] SD pupil area was 39.33 [Formula: see text] 7.1 mm [Formula: see text] preoperatively and 39.3 [Formula: see text] 6.75 mm [Formula: see text] after laser pretreatment. The mean [Formula: see text] SD change in pupil area was -0.03 [Formula: see text] 2.12 mm [Formula: see text]. There were no statistically significant changes between preoperative and post-laser pupil areas (P = 0.93, 95% CI: -0.71 to 0.65). Comparisons within subgroups also did not detect pupil area reduction. CONCLUSION: This study did not detect statistically significant changes in pupil area after laser pretreatment using low-energy FLACS. This observation is in contrast to previous studies using other laser platforms.