Pupil size as a predictor of visual outcomes with an enhanced monofocal intraocular lens

Pupil size plays a critical role in the optical performance of modern intraocular lenses, including enhanced monofocal intraocular lens. Enhanced monofocal aspheric intraocular lenses, such as the Tecnis Eyhance ICB00, are designed to provide improved intermediate vision without compromising distance acuity. However, visual outcomes may vary among patients, and pupil size has been proposed as a contributing factor. Accurate assessment of pupil size using anterior segment swept-source optical coherence tomography (AS SS-OCT) devices may help identify patients who would benefit most from these intraocular lenses. This retrospective study included 64 eyes from 45 patients who underwent uncomplicated cataract surgery with implantation of the Tecnis Eyhance ICB00 intraocular lens. Preoperative pupil size was measured using both the Anterion® and IOLMaster 700 AS SS-OCT devices; postoperative measurements at one month were obtained with Anterion. UCDVA was analysed based on pupil size thresholds of 3.5 mm and 4.0 mm. intraocular lens thickness profiles of Eyhance and a conventional monofocal intraocular lens (Tecnis ZCB00) were compared. Postoperative pupil size ≥4.0 mm (Anterion) was associated with significantly better UCDVA (LogMAR 0.08 ± 0.08) compared to p p Preoperative and postoperative pupil size ≥4.0 mm, as measured by Anterion, was associated with better UCDVA with enhanced monofocal intraocular lenses. However, further research is needed to confirm if this results from the lens design or physiological confounders like diffraction. Measurement discrepancies between AS SS-OCT devices highlight the need for standardisation.