Influences of Luminance and Accommodation Stimuli on Pupil Size and Pupil Center Location

Mathur, Ankit; Gehrmann, Julia; Atchison, David A.

doi:10.1167/iovs.13-13492

Cited by 58 publications

(55 citation statements)

References 15 publications

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“…Qi et al reported a positive correlation in horizontal and vertical components of kappa angle in preoperative sitting position measured via Pentacam and intraoperative supine position measured via the Allegretto Wavelight Excimer Laser System (WaveLight Laser Technologie AG). [38] Therefore, although our measurement values may be affected by change in posture due to the effect of cyclotortion, and also due to comparing measurements across different platforms, a positive correlation between measured values in different postures and platforms has already been previously described. [39] In retrospect, it may still be beneficial to have postoperative topography to confirm accuracy of centration analysis.…”

Section: Discussionmentioning

confidence: 90%

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Intraoperative centration during small incision lenticule extraction (SMILE)

Wong

Htoon

et al. 2017

Medicine

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To evaluate intraoperative decentration from pupil center and kappa intercept during small incision lenticule extraction (SMILE) and its impact on visual outcomes.This was a retrospective noncomparative case series. A total of 164 eyes that underwent SMILE at the Singapore National Eye Center were included. Screen captures of intraoperative videos were analyzed. Preoperative and 3 month postoperative vision and refractive data were analyzed against decentration.The mean preoperative spherical equivalent (SE) was −5.84 ± 1.77. The mean decentration from the pupil center and from kappa intercept were 0.13 ± 0.06 mm and 0.47mm ± 0.25 mm, respectively. For efficacy and predictability, 69.6% and 95.0% of eyes achieved a visual acuity (VA) of 20/20 and 20/30, respectively, while 83.8% and 97.2% of eyes were within ±0.5D and ±1.0D of the targeted SE. When analyzed across 3 groups of decentration from the pupil center (<0.1 mm, 0.1–0.2 mm, and >0.2 mm), there was no statistically significant association between decentration, safety, efficacy, and predictability. When analyzed across 4 groups of decentration from kappa intercept (<0.2 mm, 0.2–<0.4 mm, 0.4–<0.6 mm, and ≥0.6 mm), there was a trend toward higher efficacy for eyes with decentration of kappa intercept between 0.4 and <0.6 mm (P = .097). A total of 85.4% of eyes in the 0.4 to <0.6 mm group had unaided distance VA of 20/20 or better, as compared to only 57.8% of eyes in ≥0.6 mm group.Decentration of 0.13 mm from the pupil center does not result in compromised visual outcomes. Decentration of greater than 0.6 mm from the kappa intercept may result in compromised visual outcomes. There was a trend toward better efficacy in eyes which had decentered treatment from 0.4 to <0.6 mm from the kappa intercept. Patients with a large kappa intercept (>0.6 mm) should have their lenticule created 0.4 to 0.6 mm from the kappa intercept and not close to the pupil.

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Section: Discussionmentioning

confidence: 90%

“…Mathur et al [38] studied the change in position of pupil center in relation to pupil size changes due to luminance adjustments. The average shift of pupil center was 0.12 mm nasally, with maximum shifts of 0.5 mm.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative centration during small incision lenticule extraction (SMILE)

Wong

Htoon

et al. 2017

Medicine

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“…Although it is known that accommodation plays a significant role in controlling pupil size,4 the influence of accommodation on pupil size in presbyopes is expected to be relatively small and is irrelevant when comparing the effect of luminance for the conditions of daytime outdoor vision and night time driving.…”

Section: Discussionmentioning

confidence: 99%

“…It is well established that pupil size decreases with increasing luminance 1–4. The strongest patient-related determinative factor for pupil size has been shown to be age 5–9.…”

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confidence: 99%

The Effects of Age, Refractive Status, and Luminance on Pupil Size

et al. 2016

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PurposePupil size is critical for optimal performance of presbyopic contact lenses. Although the effect of luminance is well known, little information is available regarding other contributing factors such as aging and refractive status.MethodsThe cohort population comprised 304 patients (127 male, 177 female) aged 18 to 78 years. Pupils were photographed at three controlled luminance levels 250, 50, and 2.5 cd/m2 using an infra-red macro video camera. Measurements of pupil diameter were conducted after transforming pixel values to linear values in millimeters.ResultsLuminance was the most influential factor with pupil diameter increasing with decreased luminance (p < 0.001, all comparisons). Age was also found to be a significant factor with a smaller diameter in the older groups, but overall the difference was only significant between the pre-presbyopes and the established presbyopes (p = 0.017). Pupil diameter decreased significantly with increasing age, the effect being most marked at low luminance (<0.001). The smallest pupil diameters were measured for hyperopes and the largest for myopes and although refractive error was not a significant factor alone, there was a significant interaction between luminance and refractive error with the greatest differences in pupil diameter between myopes and emmetropes at low luminance (p < 0.001). Pupil diameter changes modeled by multilinear regression (p < 0.001) identified age, luminance, best sphere refraction, and refractive error as significant factors accounting for just over 70% of the average variation in pupil diameter.ConclusionsBoth age and refractive status were found to affect pupil size with larger pupils measured for younger patients and myopes. Designs for multifocal contact lens corrections should take both age and refractive status into consideration; a faster progression from distance to near corrections across the optical zone of the lens is expected to be required for established presbyopes and hyperopes than it is for early presbyopes, myopes, and emmetropes.

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“…The pupillary centroid shifts with pharmacological dilatation, change in accommodation, illumination and during excimer ablation …”

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Assessment of bilateral pupillary centroid characteristics at varying illuminations and post‐photopic flash response using an automated pupillometer

Prakash¹,

Srivastava²,

Suhail³

et al. 2016

Clinical and Experimental Optometry

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Influences of Luminance and Accommodation Stimuli on Pupil Size and Pupil Center Location

Abstract: Variations in luminance and accommodation influence pupil size, but only the former affects pupil center location significantly. Pupil center shifts are too small to be of concern in fitting progressive addition lenses.

Cited by 58 publications

References 15 publications

Intraoperative centration during small incision lenticule extraction (SMILE)

Intraoperative centration during small incision lenticule extraction (SMILE)

The Effects of Age, Refractive Status, and Luminance on Pupil Size

Assessment of bilateral pupillary centroid characteristics at varying illuminations and post‐photopic flash response using an automated pupillometer

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