1. Optimum pinhole size determination in pinhole pupilloplasty for higher-order aberrations.
- Author
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Kumar, Dhivya Ashok, Narang, Priya, Holladay, Jack, Sivagnanam, Soundari, Narang, Rhea, Agarwal, Ashvin, and Agarwal, Amar
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PUPILLOMETRY , *ROOT-mean-squares , *CLINICAL trials , *VISUAL acuity - Abstract
Purpose: To determine optimal pinhole size (OPS) and establish a relationship with visual acuity (VA) and RMS (root mean square) values in cases with higher-order aberrations (HOAs) undergoing pinhole pupilloplasty (PPP). Setting: Private practice, India. Design: Prospective, interventional study. Methods: RMS value for 6-mm--diameter optical zone was determined by Scheimpflug imaging (Pentacam). Patients with RMS value >0.3 mm were included. Preoperatively, a hand-held pinhole gauge with varied apertures determined the OPS, and single-pass four-throw technique was used to perform pupilloplasty with Purkinje-1 reflex as a marker for centration. VA with OPS, correlation of RMS values with OPS and pupil size, and Strehl ratio were the main outcome measures. Results: 29 eyes with HOAs were analyzed; all patients chose 1.0 or 1.5 mm as OPS. The mean preoperative and postoperative pupil size was 3.25 ± 0.81 mm and 1.8 ± 0.54 mm (P = .000), respectively. Postoperative mean pupil size when compared with OPS denoted that 14 eyes had a difference of <0.1 mm, 8 eyes ranged from 0.2 to 0.45 mm, and 7 eyes had ≥0.6 mm (range from 0.6 to 1.8 mm) difference from OPS. Eyes with higher RMS values needed smaller pupil gauge to achieve better VA. Preoperatively, vision with OPS correlated well with preoperative 6-mm RMS HOAs (r = 0.728; P = .00). Postoperative UDVA correlated well with VAmeasured with OPS (r = 0.847; P = .00). The preoperative and postoperative mean Strehl ratio was 0.109 ± 0.07 and 0.195 ± 0.11 (P = .001), respectively. Conclusions: Higher RMS values required a smaller pupil to achieve optimum VA. PPP can help achieve pinhole size in accordance with patient's optimum pinhole requirement. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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