Effect of capsulorhexis diameter on glare disability

Purpose: To determine whether the diameter of the anterior capsulorhexis has an effect on postoperative glare. Setting: Sapir Medical Center, Meir Hospital, Kfar Saba, Israel. Methods: Forty patients had extracapsular cataract extraction (manual or phacoemulsification) through an intact continuous curvilinear capsulorhexis (CCC) of various sizes. The CCC diameter was measured and the opacity of the anterior and posterior capsules was evaluated before and after dilation of the pupils. Glare test (Miller-Nadler glare tester) was performed with the eyelid in a normal position and after lid elevation. Results: The diameter of the CCC ranged from 3.50 to 7.00 mm (mean 4.87 mm). The anterior capsule was always opaque in the area of contact with the IOL material. None was graded clear; 60% were graded as +3. Mean glare disability prior to pupil dilation was 12.1 ± 8.8 (SD) and after dilation, 17.3 ± 9.7. There was no correlation between glare disability and the diameter of the capsulorhexis, the width of the exposed opacified capsular ring, or the grading of capsule opacification (anterior and posterior). Dilation of the pupil significantly increased glare disability (P = .016), unrelated to CCC diameter. Conclusion: A CCC larger than 3.5 mm does not induce significant glare.