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Gregory W. Schmidt, MD; Michael Yoon, MD; Gerald McGwin, PhD; Paul P. Lee, MD, JD; Stephen D. McLeod, MD

Arch Ophthalmol. 2007;125(8):1037-1042.

Objective  To evaluate the relationship between ablation diameter, pupil size, and visual function as measured by a vision-specific quality-of-life instrument after undergoing laser in situ keratomileusis.

Methods  Of 300 patients eligible for this study, 97 (32.3%) responded to a mailed study questionnaire, the National Eye Institute Refractive Error Quality of Life (RQL) Instrument. The RQL Instrument was administered in all 97 patients after laser in situ keratomileusis. Spearman correlation coefficients were calculated for the association between RQL subscale scores and characteristics including pupil diameter and uncorrected visual acuity.

Results  Positive correlations between larger mesopic and scotopic pupil diameter and higher RQL satisfaction scores (0.12 and 0.19, respectively) were not statistically significant at the P = .05 level. As uncorrected visual acuity in the better eye improved, patients reported significantly less worry (–0.22; P = .03), more satisfaction (–0.25; P = .01), clearer vision (–0.25; P = .01), and better far vision (–0.24; P = .02).

Conclusion  Larger pupil diameter is not significantly associated with postoperative satisfaction and visual function as measured with the RQL. Rather, postoperative uncorrected visual acuity is confirmed as a strong predictor of patient satisfaction after refractive surgery.

Author Affiliations: From the Department of Ophthalmology (Drs Schmidt, Yoon, and McLeod) and the Francis I. Proctor Foundation for Research in Ophthalmology (Dr McLeod), University of California, San Francisco; Department of Ophthalmology, Clinical Research Unit, University of Alabama, Birmingham (Dr McGwin); and Duke University Eye Center, Durham, North Carolina (Dr Lee). Dr Schmidt is now affiliated with the Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

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