1.Mesopic Pupillometry in Pre-LASIK Patients by a Placido-Disc Topographer and Hartmann-Shack Aberrometer
Md Mustafa Md-Muziman-Syah ; Muhammad Aiman Suhaimi ; Umar Hakimi Sulaiman ; Noorhazayti Ab. Halim ; Ahmad Tajudin Liza-Sharmini ; Khairidzan Mohd Kamal
Malaysian Journal of Medicine and Health Sciences 2021;17(No.2):197-202
Introduction: Precise pupillometry is crucial to determine ablation optical zone (OZ) size selection in LASIK. Significant difference in the selection induces unwanted postoperative night visual disturbance. Placido-disc topographer
and Hartmann-Shack aberrometer are commonly used in LASIK preoperative assessment. However, little is known
on the precision and agreement of these devices in pupillometry. Hence, this study aimed to evaluate the precision
(repeatability and reproducibility) and inter-device agreement of a Placido-disc topographer and Hartmann-Shack
aberrometer in measuring mesopic pupil size in pre-LASIK patients. Methods: Mesopic pupillometry on 38 pre-LASIK
patients were performed using both devices by two masked operators, on two separate sessions. Intra-session repeatability, inter-operator reproducibility and inter-device agreement were analysed. A disagreement value of ±0.5 mm
and 95% limits of agreement (LoA) were determined. Results: Hartmann-Shack aberrometer demonstrated higher
repeatability and reproducibility than Placido-disc topographer in mesopic pupillometry. Ninety-seven percent and
all of Hartmann-Shack wavefront aberrometer pupillometry were within ±0.5 mm in repeated sessions and between
the operators, respectively. The mesopic pupil size obtained from Placido-disc topographer was significantly larger
than Hartmann-Shack aberrometer results (P = 0.02). The agreement between devices was low (LoA > ±1 mm) and
only 53% of Placido-disc topographer pupillometry were within ±0.5 mm of Hartmann-Shack aberrometer pupillometry. Conclusion: Hartmann-Shack aberrometer has higher precision within sessions and between operators, and
it provides smaller mesopic pupillometry than Placido-disc topographer. Precise mesopic pupillometry could assist
refractive surgeons in choosing a correct ablation OZ size during LASIK surgery to improve postoperative outcome.