Pupil size differences between female and male patients after cataract surgery

PURPOSE: To evaluate the changes in pupil diameter in women and men after cataract surgery. The correlation of pupillary changes with the variables age and anterior chamber depth will be analyzed. METHODS: The values of 109 randomized eyes who underwent cataract surgery were obtained and divided into two groups, 71 women and 38 men. Pupil diameter was measured preoperatively and 3-months postoperatively using the pupillometer software of the Topolyzer Vario (Wavelight Laser Technologie AG). Anterior chamber depth was obtained with Pentacam® (Oculus). Differences in pupillary diameters were investigated and correlations with age and anterior chamber depth were analyzed. RESULTS: For mesopic pupils, the male group had greater reduction in their postoperative pupillary diameter, −0.56 mm (−12.4%), than the female group, −0.38 mm (−8.2%), P = 0.025. Photopic postoperative pupils reduced to a lesser extent, yet more in men than in women (−0.11mm [−4.5%] vs. −0.04 [−1.6%], P = 0.048). Weak significant negative correlation was found between photopic pupillary changes in women with age (r = −0.24, P = 0.041), and positive correlation for mesopic pupillary changes in men with age (r = +0.34, P = 0.039). CONCLUSIONS: Patients experience pupil reduction after cataract surgery in general, but more in men than in women and for both photopic and mesopic lighting conditions. The differences are statistically significant and have moderate clinical relevance. Concerning pupillary changes, weak but opposite sign correlations were found between male/female gender and age. Trial registration number at ClinicalTrials.gov Identifier: NCT04286646.