1-Minute Video
    Cataract/Anterior Segment, Refractive Mgmt/Intervention

    In this 1-Minute Video, Drs. Priya Narang and Amar Agarwal describe the use of Purkinje images to assess centration during pinhole pupilloplasty surgery. Purkinje images are produced due to reflection of light from the corneal and lenticular interface. Of the 4 Purkinje images, Purkinje image 1 is considered to be the main reference marker. Surgeons can use the Lumera surgical microscope (Zeiss) to project a Purkinje image with 3 light reflections—2 co-axial lights at the bottom and 1 light on the top from the main illumination light. During surgery, centering the pinhole pupilloplasty to the P 1 reflex ensures a decrease in ‘‘chord μ,’’ or chord length, which represents the distance between the pupillary center to the visual axis. Post PPP, there is a significant decrease in chord μ for cases with higher order aberrations that is the likely explanation for the improvement in visual and image quality.

    Relevant Financial Disclosures: None