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Pupil centre shift between bright light and dim light conditions

Pupil centre shift between bright light and dim light conditions. C. Winkler von Mohrenfels 1 , J Salgado 1, R. Khoramnia 1 , Christian Wüllner 2 , Peter Riedel 2 , C Donitzky 2 1Augenklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany, Financial interest: none

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Pupil centre shift between bright light and dim light conditions

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  1. Pupil centre shift between bright light and dim light conditions C. Winkler von Mohrenfels1, J Salgado1, R. Khoramnia1, Christian Wüllner2, Peter Riedel2, C Donitzky2 1Augenklinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany, Financial interest: none 2 WaveLight AG Erlangen, financial interest: employee

  2. Problem • different pupil size between dim and bright light condition • centration of laser ablation: pupil center, apex, line of sight • eye tracking: pupil, iris • pupil shift between the different light conditions could lead to miss alignment of the laser ablation. Method • 47 healthy subjects both eyes (12♂, 35 ♀), • mean age 36 years (range 23 to 60) • WaveLight Allegro Topolyzer: Pupil software (dim [20 lux] and bright light [455 lux] conditions)

  3. Pupil difference and age 5.0 4.5 4.0 3.5 3.0 Pupil devition between dim and britgh light conditions in [mm] 2.5 2.0 1.5 y = -0.0252x + 3.8457 R 2 = 0.2163 1.0 0.5 0.0 10 20 30 40 50 60 70 age in [years]

  4. Pupil center shift right eye x axis 0.5 0.4 0.3 0.2 0.1 temporal • y-axis nasal 0.0 -0.5 -0.4 -0.3 -0.2 -0.1 0.0 0.1 0.2 0.3 0.4 0.5 -0.1 -0.2 -0.3 -0.4 -0.5 MW 105µm (SD 65; min 18µm; max 330µm)

  5. Pupil center shift left eye x-axis 0.5 0.4 0.3 0.2 0.1 y- axis nasal temporal 0.0 -0.5 -0.4 -0.3 -0.2 -0.1 0.0 0.1 0.2 0.3 0.4 0.5 -0.1 -0.2 -0.3 -0.4 -0.5 MW 107µm (SD 64; min 11µm; max 348µm)

  6. Conclusions • the average pupil shift is 0.11mm • most pupils shift to temporal side • huge variation 0.01mm to 0.348mm • the larger pupils shifts could lead to a miss alignment between tracking and laser ablation. • → risk of decentration and poor visual outcome

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