Mesopic pupil indices as potential risk factors for disability glare after intraocular Implantable Collamer Lens implantation: A prospective study

To explore the influence of preoperative factors, including varying pupil sizes and refractive attributes, on postoperative disability glare in patients undergoing Implantable Collamer Lens (ICL) implantation.Second Affiliated Hospital, Nanchang University.Prospective observational study.We analyzed the preoperative ocular characteristics and six-month postoperative glare status in eligible patients who underwent EVO-Visian ICL V4c (VICMO) implantation. The disability glare criteria encompassed a glare symptom score >6 and glare sensitivity exceeding 1:2.7. Logistic regression analysis was used to explore the relationship between the preoperative ocular parameters and post-ICL glare.The study included 95 patients (mean age, 26.04 ± 6.29 years), comprising 30 males (58 eyes) and 65 females (129 eyes). Multivariate analysis revealed a significant correlation between postoperative disability glare and increased spherical power in preoperative mesopic pupils (β = -0.124, p = 0.039), as well as elevated cylinder power in preoperative mesopic (β = -0.412, p = 0.009) and photopic pupils (β = -0.430, p = 0.007). Moreover, a larger preoperative mesopic pupil diameter (β = 0.561, p = 0.005) demonstrated a significant correlation with disability glare.Preoperative mesopic pupil dimensions and associated refractive parameters, such as sphere and cylinder were correlated with disability glare, including the cylinder aspect in photopic pupils, which can assist clinicians in optimizing preoperative selection for ICL implantation, aiding in the anticipation of potential disability glare risks.