Incidence of Intraoperative Miosis in Laser-Assisted Cataract Surgery
Purpose
To determine the incidence of intraoperative miosis following femtosecond capsulotomy, fragmentation and creation of corneal incisions.
Methods
Prospective series of cases, forty five eyes of 31 patients who underwent femtosecond assisted cataract surgery. Patients who used alpha-1 adrenergic antagonists and eyes with pseudoexfoliation syndrome were included in the study. Preoperative drops of 2.5% neosynephrine, 1% cyclopentolate and 1% tropicamide were instilled 30-60 minutes prior to measurement of the pupil and subsequent application of femtosecond laser. Non-steroidal anti-inflammatory eye drops were not used. The pupil size was measured again intraoperatively prior to the opening of corneal incisions. T- test was used to analize results.
Results
A reduction in pupil size ≥0.5mm was observed in 2/3 of eyes (64%, N=29) following the femtosecond laser procedure. No change was noted 1/3 of eyes (36%, N=16).
The degree of pupillary constriction was between 0.5 to 1.5mm in 42% (N=19), 2-3.5mm in 13% (N=6) and ≥ 4mm in 9% (N=4) of eyes. Use of alpha-1 adrenergic antagonists or presence of pseudoexfoliation was not associated with greater pupillary constriction.
Conclusion
Significant pupillary miosis ≥ 4mm was observed in 9% (N=4) of eyes following the femtosecond laser procedure. Surgeons should be prepared to appropriately manage intraoperative miosis during femtosecond assisted cataract surgery.