Investigation of Pupillary Responses in Healthy Eyes and Eyes Implanted with Multifocal or Monofocal Intraocular Lenses

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Purpose Comparison of dynamic pupillary parameters (DPPs) between healthy volunteers and multi- or monofocal intraocular lens (IOL) implanted eyes, and examination of the correlation between postoperative visual acuity (VA), contrast sensitivity (CS), visual dysphotopsias (VD), and these parameters in IOL-implanted eyes. Methods This cross-sectional study classified and analyzed DPPs from healthy volunteers (308 eyes) according to age. In the multifocal IOL group (119 eyes), 51 eyes were implanted with Lentis Comfort® (L group), 32 with PanOptix® (P group), and 36 with Synergy® (S group). The monofocal IOL group included 33 eyes implanted with Vivinex Impress® (V group). DPPs by the pupillometer (PLR-3000), distance, intermediate and near VA, and CS and VD were examined one month postoperatively in 152 eyes. Results Significant decreases in maximum or minimum pupillary diameter (INIT, END), percentage of pupillary constriction (DELTA), latency between light stimulation and constriction (LAT), and average and maximum constriction velocity (ACV, MCV), average dilation velocity (ADV), were observed with aging in the healthy eyes group. The preoperative group showed a significant age-related decrease in DELTA and increase in LAT. The postoperative group showed a significant age-related decrease in INIT, END, and ADV. The L group exhibited a significant positive correlation between ADV and uncorrected intermediate VA (UIVA), while the P group exhibited a significant positive correlation between ACV and UIVA, and the S group exhibited a significant negative correlation between ACV and uncorrected near VA. For CS, the S group exhibited a significant positive correlation with ADV at 1.0 and 0.7 degrees, and the P group exhibited a significant negative correlation between ACV and glare. Conclusion DPPs are greatly affected by age. DPPs for multi- or monofocal IOL eyes correlate with uncorrected VA, CS, and VD.