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Jo E, Kim SM, Kim JM, Han SY. Changes in ocular biometrics following cycloplegic refraction in strabismic and amblyopic children. Medicine (Baltimore) 2024; 103:e38143. [PMID: 38758890 PMCID: PMC11098244 DOI: 10.1097/md.0000000000038143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/15/2024] [Indexed: 05/19/2024] Open
Abstract
This study was aimed to analyze ocular biometric changes following cycloplegia in pediatric patients with strabismus and amblyopia. Cycloplegia is routinely used to measure refractive error accurately by paralyzing accommodation. However, effects on axial length (AL), anterior chamber depth (ACD), keratometry (Km), and white-to-white distance (WTW) are not well studied in this population. This retrospective study examined 797 patients (1566 eyes) undergoing cycloplegic refraction at a Samsung Kangbuk hospital pediatric ophthalmology clinic from 2010 to 2023. Ocular biometry was measured before and after instilling 1% cyclopentolate and 0.5% phenylephrine/0.5% tropicamide. Patients were categorized by strabismus diagnosis, age, refractive error and amblyopia status. Differences in AL, ACD, Km, WTW, and refractive error pre- and post-cycloplegia were analyzed using paired t tests. ACD (3.44 ± 0.33 vs 3.58 ± 0.29 mm, P < .05) and WTW (12.09 ± 0.42 vs 12.30 ± 0.60 mm, P < .05) increased significantly after cycloplegia in all groups except other strabismus subgroup (Cs) in both parameters and youngest subgroup (G1) in ACD. Refractive error demonstrated a hyperopic shift from -0.48 ± 3.00 D to -0.06 ± 3.32 D (P < .05) in overall and a myopic shift from -6.97 ± 4.27 to -8.10 ± 2.26 in high myopia (HM). Also, AL and Km did not change significantly. In conclusion, cycloplegia impacts ocular biometrics in children with strabismus and amblyopia, significantly increasing ACD and WTW. Refractive error shifts hyperopically in esotropia subgroup (ET) and myopically in high myopia subgroup (HM), eldest subgroup (G3) relating more to anterior segment changes than AL/Km. Understanding cycloplegic effects on biometry is important for optimizing refractive correction in these patients.
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Affiliation(s)
- Eunhui Jo
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Young Han
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Xi W, Yang M, Wan J, Wang Y, Qiao Y, Huang X, Liu X, Fan N, Liu S, Zeng K, Chen S. Effect of pupil dilation on biometry measurements and intraocular lens power in eyes with high myopia. Front Med (Lausanne) 2022; 9:963599. [PMID: 36341238 PMCID: PMC9626805 DOI: 10.3389/fmed.2022.963599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/03/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose The present study sought to evaluate the effects of pupil dilation on ocular parameter measurements and intraocular lens (IOL) power calculation using IOLMaster in highly myopic cataract patients. Materials and methods A total of 233 eyes were included in this prospective study and assigned to four groups based on range of axial length (AL) as follows: group A:26–28 mm, group B:28–30 mm, group C:30–32 mm, and group D:32–36 mm. Flattest and steepest keratometry (K1 and K2), AL, anterior chamber depth (ACD), lens thickness (LT), and white-to-white (WtW) were determined using IOLMaster before and after administration of topical tropicamide. The corresponding IOL powers were calculated using Sanders–Retzlaff–Kraff/theoretical (SRK/T), Haigis, and Barrett Universal II formulas. Results Variations in AL, K1 and K2 following dilation were not significant (P > 0.05 in all groups). The results showed that ACD increased significantly after dilation (P = 0.000 in all groups), whereas LT decreased significantly after dilation (P = 0.000, 0.000, 0.001, and 0.003). Post-dilation WtW increased significantly in Group A, B, and C (P = 0.001, 0.001, and 0.025) but not in Group D. When IOL power was calculated as a discrete variable, significant differences were observed between pre- and post-dilation IOL power. Conclusion Pupil dilation in cataract eyes with high myopia does not cause significant changes in AL and K. However, it significantly increases ACD as well as WtW values and significantly decreases the LT value. Surgeons should evaluate the effect of pupil dilation on IOL power prediction as the present findings show extreme cases. Notably, Barrett Universal II formula had the best concordance between different pupil conditions in long eyes.
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Kesim C, Yıldız-Taş A, Karslıoğlu MZ, Hasanreisoğlu M, Müftüoğlu O, Şahin A. The Effect of Anterior Segment Depth on the Accuracy of 7 Different Intraocular Lens Calculation Formulas. Turk J Ophthalmol 2022; 52:228-236. [PMID: 36016720 PMCID: PMC9421936 DOI: 10.4274/tjo.galenos.2021.43726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Sánchez-González JM, Flikier D, Nebro-Cobos S, Zamorano-Martín F, Rachwani-Anil R, García-Lorente M, Borroni D, Peraza-Nieves J, Rocha-de-Lossada C. The Combined Effect of Tropicamide and Phenylephrine on Corneal Astigmatism Axis. Curr Eye Res 2021; 47:179-186. [PMID: 34437825 DOI: 10.1080/02713683.2021.1971720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To analyze astigmatism axis changes after tropicamide and phenylephrine combined instillation. METHOD One hundred and thirty-one eyes from 66 patients enrolled this cross-sectional study. An extensive ocular examination was carried out prior to tropicamide and phenylephrine instillation. Power and axis value from flat, steep, and mean keratometry were calculated using an Auto Kerato-Refractometer (AKR). Later, topography and tomography maps were evaluated with Pentacam HR® (Oculus, Wetzlar, Germany). Subsequently, a single drop of tropicamide 1% and phenylephrine hydrochloride 10% were instilled twice, with a five-minute gap between each instillation. After 30 minutes, the AKR and Pentacam HR® tests were repeated. RESULTS Incyclotorsion was found in 59 eyes (45.1%) and mean absolute incyclotorsion change was 3.91 ± 3.62 degrees (0.10 to 14.20). Excyclotorsion was found in 72 eyes (54.9%) and mean excyclotorsion change was 4.99 ± 5.94 degrees (0.20 to 36.20). We observed that 74.6% and 68.1% of eyes experienced incyclotorsion and excyclotorsion within 0 to 5 degrees, respectively. Fewer patients experienced incyclotorsion and excyclotorsion changes within 5 to 10 degrees, precisely 11.8% and 19.4%, respectively. Eyes that experienced over 10 degrees of incyclotorsion and excyclotorsion were 13.6% and 12.5%, respectively. CONCLUSION Astigmatism axis could change after combined tropicamide and phenylephrine instillation. Reference axis marking in astigmatism correction surgery should be performed under the same circumstances as the astigmatism axis has been measured.
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Affiliation(s)
| | - David Flikier
- Department of Ophthalmology, Ocular Surgery Institute, San José, Costa Rica
| | | | | | - Rahul Rachwani-Anil
- Department of Ophthalmology, Regional University Hospital of Málaga, Málaga, Spain
| | - María García-Lorente
- Department of Ophthalmology, Regional University Hospital of Málaga, Málaga, Spain
| | - Davide Borroni
- Department of Doctoral Studies, Riga Stradins University, Riga, Latvia.,Ophthalmology, Fondazione Banca Degli Occhi del Veneto Onlus, Venezia, Italy
| | | | - Carlos Rocha-de-Lossada
- Department of Ophthalmology, Clinic Barcelona Hospital, Barcelona, Spain.,Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain.,Department of Ophthalmology, Hospital Virgen de Las Nieves, Granada, Spain
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Tasci YY, Yesilirmak N, Yuzbasioglu S, Ozdas D, Temel B. Comparison of effects of mydriatic drops (1% cyclopentolate and 0.5% tropicamide) on anterior segment parameters. Indian J Ophthalmol 2021; 69:1802-1807. [PMID: 34146033 PMCID: PMC8374771 DOI: 10.4103/ijo.ijo_2677_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The purpose of this study is to investigate and compare the effects of cyclopentolate and tropicamide drops on anterior segment parameters in healthy individuals. Methods Two hundred and fifty-eight eyes of 129 healthy volunteers were included in this randomized clinical study. Cyclopentolate 1% drop was applied to 75 (58%) participants (group 1) and tropicamide 0.5% drop was applied to 54 (42%) participants (group 2). Flat keratometry (K1), steep keratometry (K2), axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), white-to-white (WTW) distance, pupil diameter, total pupil offset and intraocular lens (IOL) power were measured before and after drops, using Lenstar 900 optical biometry. Results The increase in CCT, ACD, pupil diameter, and pupil offset was significant in group 1 after the drop (P < 0.05), while the increase in ACD, pupil diameter, and pupil offset was significant in group 2 (P < 0.05). When the two groups were compared, there was no significant difference in K1, K2, CCT, ACD, WTW, pupil diameter, pupil offset, and IOL power (using Sanders-Retzlaff-Kraff T formula) changes after drops (P > 0.05), whereas the change in AL was significant (P = 0.01). Conclusion The effects of cyclopentolate and tropicamide drops on anterior segment parameters were similar; they did not make significant changes in K1, K2, AL, WTW, and third-generation IOL power calculation. However, ACD values significantly changed after these drops; thus, measuring anterior segment parameters before mydriatic agents should be taken into account particularly for fourth-generation IOL formulas and phakic IOL implantation. The change in pupil offset, which can be important in excimer laser and multifocal IOL applications, was not clinically significant.
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Affiliation(s)
| | - Nilufer Yesilirmak
- Department of Ophthalmology, Ankara City Hospital; Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Sema Yuzbasioglu
- Department of Ophthalmology, Ankara City Hospital; Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Demet Ozdas
- Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara; Department of Ophthalmology, Midyat State Hospital, Mardin, Turkey
| | - Berke Temel
- Department of Ophthalmology, Ankara City Hospital; Department of Ophthalmology, Ankara Yildirim Beyazit University, Ankara, Turkey
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Bourdon H, Trinh L, Robin M, Baudouin C. Assessing the correlation between swept-source optical coherence tomography lens density pattern analysis and best-corrected visual acuity in patients with cataracts. BMJ Open Ophthalmol 2021; 6:e000730. [PMID: 34046526 PMCID: PMC8126301 DOI: 10.1136/bmjophth-2021-000730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/03/2021] [Accepted: 04/26/2021] [Indexed: 01/31/2023] Open
Abstract
Objective To assess linear correlation between swept-source optical coherence tomography (SS-OCT) lens density variation and patients’ best-corrected visual acuity (BCVA). Methods and analysis Linear densitometry was performed on horizontal lens images from 518 eyes, obtained using SS-OCT. All densities from the anterior to the posterior side of the cataract were exported for detailed analysis. The algorithm used a classical random forest regression machine learning approach with fourfold cross-validation, meaning four batches of data from 75% of the eyes with known preoperative best-corrected visual acuity (poBCVA) were used for training a model to predict the data from the remaining 25% of the eyes. The main judgement criterion was the ability of the algorithm to identify linear correlation between measured and predicted BCVA. Results A significant linear correlation between poBCVA and the algorithm’s prediction was found, with Pearson correlation coefficient (R)=0.558 (95% CI: 0.496 to 0.615, p<0.001). Mean BCVA prediction error was 0.0965±0.059 logarithm of the minimal angle of resolution (logMAR), with 312 eyes (58%) having a BCVA prediction correct to ±0.1 logMAR. The best algorithm performances were achieved for 0.20 logMAR, with 79%±0.1 logMAR correct prediction. Mean, anterior cortex, nucleus and posterior cortex pixel density were all not correlated with patient BCVA. Conclusion Pixel density variations based on axial lens images provided by SS-OCT biometer provide reasonably accurate information for machine learning analysis to estimate patient BCVA in all types of cataracts. This study demonstrates significant linear correlation between patients’ poBCVA and the algorithmic prediction, with acceptable mean prediction error.
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Affiliation(s)
| | | | | | - Christophe Baudouin
- III, CHNO, Paris, Île-de-France, France.,Department of Ophthalmology, Hôpital Ambroise-Pare, Boulogne-Billancourt, France
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Ozcaliskan S, Yenerel NM. The effect of cycloplegia on biometric measurements using swept‐source optical coherence tomography‐based biometry. Clin Exp Optom 2021; 102:501-505. [DOI: 10.1111/cxo.12888] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 01/01/2019] [Accepted: 01/06/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sehnaz Ozcaliskan
- Beyoglu Eye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey,
| | - Nursal Melda Yenerel
- Haydarpasa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey,
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Pujari A, Agarwal D, Sharma N. Clinical role of swept source optical coherence tomography in anterior segment diseases: a review. Semin Ophthalmol 2021; 36:684-691. [PMID: 33689554 DOI: 10.1080/08820538.2021.1897854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To note the comprehensive role of swept source anterior segment optical coherence tomography (SS-ASOCT) in anterior segment diseases. METHODS A systematic literature search was carried out on various medical databases using the keywords, swept source anterior segment optical coherence tomography; SS-ASOCT; Cornea and SS-ASOCT; SS-ASOCT and glaucoma; SS-ASOCT and cataract; SS-ASOCT and biometer; SS-ASOCT and tear film and ocular surface.Original works and novel reports describing the potential role of SS-ASOCT in various anterior segment conditions were included. RESULTS After a thorough assessment of literature, it was clear that the SS-ASOCT did provide newer insights into many anterior eye conditions. The rapid scan acquisition, deeper tissue penetration, and higher magnification did enhance many of our understandings, which were previously not possible. In addition, lenticular assessment under complex clinical scenarios with automated values on objective scale has made it a worthy tool with immense future possibilities. CONCLUSIONS SS-ASOCT unveiled various anterior segment findings which were of clinical importance.
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Affiliation(s)
- Amar Pujari
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Divya Agarwal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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The effect of cycloplegia on the ocular biometry and intraocular lens power based on age. Eye (Lond) 2020; 35:676-681. [PMID: 32796931 DOI: 10.1038/s41433-020-01131-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To investigate the effect of cycloplegia on the ocular biometry and intraocular lens (IOL) power in different age groups. METHODS This cross-sectional study enrolled 240 right eyes of 240 healthy volunteers. Three groups were formed (range to years; group 1: 50-60, group 2: 30-40 and group 3: 10-20, respectively). We measured keratometry, central corneal thickness (CCT), white-to-white (WtW) distance, anterior chamber depth (ACD), and axial lentgh (AL) both before and after cycloplegia. The IOL powers were calculated using Sanders-Retzlaff-Kraff/theoretical (SRK/T), Holladay 1 and Haigis formulas. AL-Scan (Nidek Co., Gamagori, Japan) was used for all measurements. RESULTS There was a significant increased in keratometry, CCT, ACD, AL, and Holladay 1 after cycloplegia (p < 0.05), whereas WtW, SRK/T, and Haigis were not changed significantly in group 1 (p > 0.05). Keratometry, SRK/T, Haigis, and Holladay 1 significantly decreased; ACD and WtW significantly increased postcycloplegia (p < 0.05) but AL and CCT did not change significantly in group 2 (p > 0.05). Significant increased in ACD, CCT, WtW, and AL, significant decreased in SRK/T and Haigis were observed postcycloplegia (p < 0.05), while the changes in keratometry and Holladay 1 were not significant in group 3 (p > 0.05). CONCLUSIONS This study demonstrated there is significant difference in many ocular parameters and IOL power formulas before and after cycloplegia. Especially, ACD showed significant changes in all age groups. Therefore, to avoid refractive prediction errors the IOL power calculation formulas using the ACD should be considered.
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Teshigawara T, Meguro A, Mizuki N. Influence of pupil dilation on the Barrett universal II (new generation), Haigis (4th generation), and SRK/T (3rd generation) intraocular lens calculation formulas: a retrospective study. BMC Ophthalmol 2020; 20:299. [PMID: 32689973 PMCID: PMC7372826 DOI: 10.1186/s12886-020-01571-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the surge in the number of cataract surgeries, there is limited information available regarding the influence of pupil dilation on predicted postoperative refraction and its comparison with recommended various intraocular lens power calculated using the different parameters. We used three different IOL power calculation formulas: Barrett Universal II (Barrett) (5-variable formula), Haigis (3-variable formula), and SRK/T (2-variable formula), in order to investigate the potential effect of pupil dilation on the predicted postoperative refraction (PPR) and recommended intraocular lens (IOL) power calculation. METHODS This retrospective study included 150 eyes. All variables were measured and calculated using a ZEISS IOL Master 700. The following variables were measured before and after dilation: anterior chamber depth (ACD), lens thickness (LT), white-to-white (WTW). PPR and recommended IOL power were calculated by Barrett, Haigis, and SRK/T IOL calculation formulas. The change in each variable before and after dilation, and the correlations between all changes were analyzed using the Wilcoxon signed-rank test and the Spearman's rank-order correlation test, respectively. RESULTS The mean absolute change (MAC) in PPR before and after dilation was found to be highest in the Barrett formula. Significant differences were found between each MAC (P < 0.0001). Significant changes were observed before and after dilation in ACD and LT (P < 0.0001), but not in WTW. Using the Barrett and Haigis formulas, there was a significant positive correlation between the change in PPR and change in ACD (P < 0.0001), and a negative correlation between change in PPR and change in LT (P < 0.0001). The correlations were strongest with the Barret formula followed by the Haigis, particularly in terms of LT. Changes in PPR determined by the Barrett formula also demonstrated a significant positive correlation with changes in WTW (P = 0.022). The recommended IOL power determined using Barrett and Haigis changed before and after dilation in 23.3 and 19.3% cases respectively, while SRK/T showed no change. CONCLUSIONS In terms of PPR and recommended IOL power, pupil dilation influenced mostly the Barrett formula. Given the stronger correlation between the changes in PPR when using Barrett and the changes in ACD, LT, and WTW, changes in ACD, LT, and WTW significantly affect how dilation influences the Barrett formula. Determining how dilation influences each formula and other variables is key to improving the accuracy of IOL calculations.
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Affiliation(s)
- Takeshi Teshigawara
- Department of Ophthalmology, Yokosuka Chuoh Eye Clinic, 238-0008, 2-6 Odaki-cho, Yokosuka, Kanagawa, Japan. .,Department of Ophthalmology, Yokohama Tsurumi Chuoh Eye Clinic, Yokohama, Kanagawa, Japan. .,Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan.
| | - Akira Meguro
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
| | - Nobuhisa Mizuki
- Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
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The Effect of Pharmacological Dilation on Calculation of Targeted and Ideal IOL Power Using Multivariable Formulas. Ophthalmol Ther 2020; 9:1-11. [PMID: 32462340 PMCID: PMC7406603 DOI: 10.1007/s40123-020-00261-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Indexed: 12/19/2022] Open
Abstract
Background To examine the effect of pharmacologic dilation on biometric parameters
measured by the Lenstar LS 900, and whether these changes affect the power of the
calculated intraocular lens (IOL) using multivariable formulas in an undilated versus
pharmacologically dilated state. Methods Prospective study of 98 phakic eyes from 53 patients. Axial length (AL),
central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT),
and keratometry (K) readings were measured. The first set of measurements was taken
prior to dilation. After dilation (pupil diameter ≥ 6.0 mm), a second set of
measurements was taken. The Barrett, Olsen, Hill-RBF, Haigis, SRK/T, and Holladay I
formulas were used to calculate IOL power before and after dilation. Two calculation
methods were used: method A used a commonly available IOL targeted to achieve
the lowest myopic spheroequivalent residual refraction; method B calculated ideal IOL
power for emmetropia. Results Statistically significant increases were seen in CCT (p < 0.01), ACD (p < 0.01), and AL (p < 0.01)
whereas a statistically significant decrease was seen in LT (p < 0.01) post dilation. Using method A, the percentage of eyes
which would have received an IOL with 0.5 D or 1.0 D of higher power, if
post-dilation measurements were used, were 25.5%, 30.6%, 20.4%, and 23.5% for
Barrett, Olsen, Hill-RBF, and Haigis, respectively. Using method B, only Haigis and
Olsen had a statistically significant increase in ideal IOL power. Conclusions Pharmacologic dilation can be associated with an increase in non-custom
IOL dioptric power when using multivariable formulas, which may lead to a myopic
surprise.
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Accuracy of Intraocular Lens Power Calculation Using Anterior Chamber Depth from Two Devices with Barrett Universal II Formula. J Ophthalmol 2019; 2019:8172615. [PMID: 31662898 PMCID: PMC6778875 DOI: 10.1155/2019/8172615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 08/17/2019] [Accepted: 09/05/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose To compare the preoperative measurements of the anterior chamber depth (ACD) by the IOLMaster and Catalys; additionally, to compare the accuracy of the IOL power calculated by the Barrett Universal II formula using the two different measurements. Setting University of California, Irvine, Gavin Herbert Eye Institute in Irvine, California. Design Retrospective comparative study. Methods This study included 144 eyes of 90 patients with a mean age of 72.0 years (range 40.8 to 92.1 years) that underwent femtosecond laser-assisted cataract surgery using Catalys. Preoperative measurements of ACD were taken by the IOLMaster and Catalys. Manifest refraction and refractive spherical equivalent were measured 1 month postoperatively. Expected refractive results were compared with actual postoperative refractive results. Results The correlation between the ACD values from the two devices was good (r = 0.80). The Catalys ACD measurements yielded a larger ACD compared to the IOLMaster, with a mean difference of 0.22 mm (P < 0.0001). The correlation between the postoperative and predicted RSE of the implanted IOL power was excellent (r = 0.96). There was no statistically significant difference between the mean absolute error derived from the IOLMaster, 0.37 diopter (D) ± 0.34 (SD), and the Catalys, 0.37 ± 0.35 D (P=0.50). Conclusions The Catalys biometry yielded a significantly larger ACD value than the IOLMaster. This difference in ACD value, however, did not reflect in a statistically significant difference in IOL power calculation and refractive prediction error using the Barrett Universal II Formula.
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Momeni-Moghaddam H, Maddah N, Wolffsohn JS, Etezad-Razavi M, Zarei-Ghanavati S, Akhavan Rezayat A, Moshirfar M. The Effect of Cycloplegia on the Ocular Biometric and Anterior Segment Parameters: A Cross-Sectional Study. Ophthalmol Ther 2019; 8:387-395. [PMID: 31054123 PMCID: PMC6692795 DOI: 10.1007/s40123-019-0187-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction To evaluate the effects of cycloplegia on the biometric components and anterior segment parameters of the eye. Methods In this cross-sectional study, changes to axial length (AL), anterior chamber depth (ACD) lens thickness, anterior chamber angle (ACA) and volume, corneal thickness in the pupil center (PC), corneal curvature (CC) and white-to-white (WTW) following cycloplegia induced by tropicamide 1% in 42 eyes of patients aged 23–58 years were assessed. Biometric components and anterior segment parameters were measured using an IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany) and a Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany), respectively. Results Significant statistical changes in ACD (increased by 0.06 ± 0.05 mm; p < 0.001), anterior chamber volume (increased by 15.19 ± 10.32 mm3; p < 0.001), ACA (decreased by 2.18 ± 10.20°; p = 0.029) and lens thickness (decreased by 0.02 ± 0.03 mm; p < 0.001) were observed post-cycloplegia, while the changes in CC, corneal thickness in the PC, WTW and AL were not statistically different (p > 0.05). Also, a significant inferior displacement of the PC along the vertical axes was seen (p = 0.020). Conclusion Cycloplegia resulted in a deeper ACD and thinner lens thickness. These changes should be considered in determining intraocular lens (IOL) power to prevent refractive surprises in cataract surgery and also in the phakic IOL implantation.
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Affiliation(s)
- Hamed Momeni-Moghaddam
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.,Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasim Maddah
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - James S Wolffsohn
- Ophthalmic Research Group, Aston University, Life and Health Sciences, Birmingham, UK
| | | | | | | | - Majid Moshirfar
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, School of Medicine, University of Utah, Salt Lake City, USA. .,Utah Lions Eye Bank, Murray, UT, USA. .,HDR Research Center, Hoopes Vision, 11820 S. State Street Suite #200, Draper, UT, 84020, USA.
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Haddad JS, Rocha KM, Yeh K, Waring GO. Lens anatomy parameters with intraoperative spectral-domain optical coherence tomography in cataractous eyes. Clin Ophthalmol 2019; 13:253-260. [PMID: 30787590 PMCID: PMC6366355 DOI: 10.2147/opth.s184208] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose To study correlations of crystalline lens anatomy and position parameters obtained using intraoperative spectral-domain (SD) optical coherence tomography (OCT) in cataract patients. Methods This retrospective study evaluated biometry data from 600 eyes of 399 cataract patients (mean age: 69±8.4 years) using intraoperative anterior segment SD-OCT during femtosecond laser-assisted cataract surgery. Lens anatomy and position parameters (anterior chamber depth [ACD] – center of the anterior cornea to the anterior lens capsule, lens thickness [LT] – distance between anterior and posterior lens capsules, and lens meridian position [LMP] – distance from center of the anterior cornea to intersection of the anterior and posterior lens) obtained with intraoperative SD-OCT, were correlated among themselves and with noncontact axial length (AL). Equatorial plane position (EPP) (distance between the plane of the lens equator and anterior capsule) was also studied. Pearson’s coefficients (r-values) were determined for all correlation pairs. Results There was a moderate correlation between AL and ACD (r=0.451; P<0.001). LMP was found to correlate strongly with ACD (r=0.77; P<0.001) but very weakly with AL (r=0.089; P=0.04). There was a moderately strong inverse correlation between LT and ACD (r=−0.586; P<0.001) but the correlation between LT and AL and LT and LMP was found to be weak (r=−0.155; P<0.001 and r=−0.121, P=0.003, respectively). Correlation of the ratio of EPP/LT and LT was weakly positive (r=0.267; P<0.001). Conclusion LMP correlated strongly with ACD but only minimally with AL. LT correlated fairly strongly with ACD but only minimally with LMP. This should stimulate additional research into the relationships among ocular and crystalline lens anatomy and IOL position after cataract surgery.
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Affiliation(s)
- Jorge Selem Haddad
- Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA, .,Federal University of São Paulo, São Paulo, Brazil,
| | | | - Kaileen Yeh
- Storm Eye Institute, Medical University of South Carolina, Charleston, SC, USA,
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Wang X, Dong J, Tang M, Wang X, Wang H, Zhang S. Effect of pupil dilation on biometric measurements and intraocular lens power calculations in schoolchildren. PLoS One 2018; 13:e0203677. [PMID: 30212545 PMCID: PMC6136745 DOI: 10.1371/journal.pone.0203677] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/26/2018] [Indexed: 12/14/2022] Open
Abstract
Purpose To investigate the effect of pupil dilation on ocular biometric parameters and intraocular lens (IOL) power calculation in schoolchildren using the Lenstar LS 900. Methods One hundred forty eyes of 140 healthy schoolchildren were included in the analysis. Axial length (AL), central corneal thickness (CCT), aqueous depth (AD), anterior chamber depth (ACD), lens thickness (LT), flat keratometry (K), steep K, astigmatism, white-to-white (WTW), and iris/pupil barycenter distance were measured, before and after pupil dilation. Anterior segment length (ASL) was defined as the sum of ACD and LT, and lens position (LP) was defined as ACD plus half of the LT. The relative lens position (RLP) was defined as LP divided by AL. IOL power was calculated using the eight formulas (Hill-RBF, Barrett, Haigis, Hoffer Q, Holladay, Olsen, SRK II, and SRK/T) integrated in the Lenstar LS 900. Parameters before and after pupil dilation were compared. Results AL, AD, ACD, LT, ASL, LP, RLP, flat K, iris barycenter distance, pupil barycenter distance, and PD differed significantly after pupil dilation (P < 0.001 in all cases), as compared to before dilation. The Olsen formula demonstrated significant differences in the magnitude of astigmatism (P = 0.010) and IOL power (P = 0.003) after pupil dilation. Using the different formulas, 23.6–40.7% of participants had IOL power changes of more than 0.50 diopters, while 0.7–1.4% had IOL changes of more than 1.0 diopter after pupil dilation. Conclusions Dilated and undilated pupil size affected the Lenstar LS 900 measurement of some ocular biometric parameters, and pupil dilation led to IOL power changes exceeding 0.50 diopters with a high percentage (from 23.6% to 40.7%) in schoolchildren, which should be noticed in clinical practice.
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Affiliation(s)
- Xiaogang Wang
- Shanxi Eye Hospital, Shanxi, People’s Republic of China
| | - Jing Dong
- The First Hospital of Shanxi Medical University, Shanxi, People’s Republic of China
| | - Maolong Tang
- Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Xiaoliang Wang
- School of Aeronautics and Astronautics Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Haitao Wang
- Shanxi Eye Hospital, Shanxi, People’s Republic of China
| | - Suhua Zhang
- Shanxi Eye Hospital, Shanxi, People’s Republic of China
- * E-mail:
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Precision of a new ocular biometer in eyes with cataract using swept source optical coherence tomography combined with Placido-disk corneal topography. Sci Rep 2017; 7:13736. [PMID: 29061989 PMCID: PMC5653855 DOI: 10.1038/s41598-017-13800-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/02/2017] [Indexed: 11/08/2022] Open
Abstract
The present study was to assess the precision (repeatability and reproducibility) of a new optical biometer (OA-2000, Tomey, Japan) based on swept-source optical coherence tomography (SS-OCT) and Placido disk topography in eyes with cataracts. Seventy-eight eyes from seventy-eight patients with cataracts were evaluated. Axial length (AL), anterior chamber depth (ACD), keratometry (K) over a 2.5 mm and 3.0 mm diameter, lens thickness (LT), central corneal thickness (CCT) and white-to-white (WTW) distance were measured by 2 skilled operators. OA-2000 measurements were highly repeatable and reproducible for all parameters (intraclass correlation, 0.925 to 1.000). OA-2000 derived K-values with a diameter of 3.0mm showed narrower 95% limits of agreement (LoA) (SRK/T: −0.18 to 0.16D; Holladay 1: −0.20 to 0.19D; Hoffer Q: −0.22 to 0.20D) than those with a diameter of 2.5 mm for IOL power calculations (SRK/T: −0.20 to 0.20D; Holladay 1: −0.23 to 0.23D; Hoffer Q: −0.25 to 0.25D). The precision (repeatability and reproducibility) of the OA-2000 was excellent for all parameters. The 3.0mm diameter K-readings appear to be the most reliable choice for calculation of IOL power with the OA-2000. In addition, the average values determined from each operator’s 3 consecutive readings were more reproducible.
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