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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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Cao Y, Gu X, Zhang Y, Zhao J, Zhu D. Assessment of the effects of myopic and hyperopic anisometropia on choroidal vascular structure in children using SS-OCTA. Ophthalmic Physiol Opt 2024; 44:525-536. [PMID: 38456753 DOI: 10.1111/opo.13300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To compare large- and medium-sized choroidal vascularity and the choriocapillaris (CC) flow area in children with different refractive errors using swept-source optical coherence tomography angiography (SS-OCTA). METHODS Forty-two anisometropic children were enrolled and divided into hyperopic anisometropia (HA) and myopic anisometropia (MA) groups. SS-OCTA was performed to analyse choroidal vascularity. Mean choroidal thickness (CT), choroidal vascularity volume (CVV), choroidal vascularity index (CVI) and CC flow area were compared between the two eyes. The inter-ocular differences between the two groups were also determined. RESULTS Mean CT and CVV were highest in eyes with shorter axial lengths in both refractive groups, and the difference between the two eyes was positively correlated with the difference in axial length at the foveal region. Significant differences in the CVI in the MA group were only found in the parafoveal region. Inter-ocular differences in the CC were significantly reduced in eyes with longer axial lengths in the foveal and parafoveal regions of the HA and MA groups, respectively. Comparing inter-ocular differences, CC was significantly greater in the parafoveal region of the MA group than the HA group. CONCLUSIONS All layers of choroidal vasculature were thinner in eyes with longer axial lengths in all groups. The inter-ocular CC difference was greater in the MA than in the HA group, with similar differences in axial length. This suggests that both medium-to-large choroidal vascular and choroidal capillaries may play a role in myopia development.
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Affiliation(s)
- Yiwen Cao
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
| | - Xiaopeng Gu
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Yadi Zhang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Jingjing Zhao
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
| | - Dehai Zhu
- Department of Pediatric Ophthalmology, Peking University First Hospital, Beijing, China
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Mao Y, Li J, Qin Y, Xu Y, Liu L, Cheng H, Wu M. Association of refractive outcome with postoperative anterior chamber depth measured with 3 optical biometers. Int Ophthalmol 2024; 44:62. [PMID: 38345699 DOI: 10.1007/s10792-024-02995-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 10/19/2023] [Indexed: 02/15/2024]
Abstract
PURPOSE This study evaluated the relationship between refractive outcomes and postoperative anterior chamber depth (ACD, measured from corneal epithelium to lens) measured by swept-source optical coherence tomography (SS-OCT), optical low-coherence reflectometry (OLCR), and Scheimpflug devices under the undilated pupil. METHODS Patients undergoing cataract phacoemulsification with intraocular lens (IOL) implantation in a hospital setting were enrolled. Postoperative ACD (postACD) was performed with an SS-OCT device, an OLCR device, and a Scheimpflug device at least 1 month after cataract surgery. After adjusting the mean predicted error to 0, differences in refractive outcomes were calculated with the Olsen formula using actual postACD measured from 3 devices and predicted value. RESULTS Overall, this comparative case study included 69 eyes of 69 patients, and postACD measurements were successfully taken using all 3 devices. The postACD measured with the SS-OCT, OLCR, and Scheimpflug devices was 4.59 ± 0.30, 4.50 ± 0.30, and 4.54 ± 0.32 mm, respectively. Statistically significant differences in postACD were found among 3 devices (P < 0.001), with intraclass correlation coefficients (ICCs) and Bland-Altman showing good agreement. No significant difference in median absolute error was found with the Olsen formula using actual postACD obtained with 3 devices. Percentage prediction errors were within ± 0.50 D in 65% (OLCR), 70% (Scheimpflug), and 67% (SS-OCT) calculated by actual postACD versus 64% by predicted value. CONCLUSION Substantial agreement was found in postACD measurements obtained from the SS-OCT, OLCR, and Scheimpflug devices, with a trend toward comparable refractive outcomes in the Olsen formula. Meanwhile, postACD measurements may be potentially superior for the additional enhancement of refractive outcomes.
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Affiliation(s)
- Yan Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
| | - Jianbing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yingyan Qin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
| | - Yanxin Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
| | - Liangping Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China
| | - Huanhuan Cheng
- Department of Ophthalmology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mingxing Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, No. 7, Jinsui Road, Zhujiang Newtown, Guangzhou, China.
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Wendelstein JA, Rothbächer J, Heath M, McDonald MC, Hoffmann PC, Cooke DL, Seiler TG, Langenbucher A, Riaz KM. Influence and predictive value of optional parameters in new-generation intraocular lens formulas. J Cataract Refract Surg 2023; 49:795-803. [PMID: 37097284 DOI: 10.1097/j.jcrs.0000000000001207] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE To evaluate the accuracy of various variations of new-generation multivariate intraocular lens (IOL) power calculation using the Barrett Universal II, Castrop, Emmetropia Verifying Optical 2.0, Hill-Radial Basis Function 3.0, Kane, and PEARL-DGS formulas with and without optional biometric parameters. SETTING Tertiary care academic medical center. DESIGN Retrospective case series. Single-center study. METHODS Inclusion of patients after uneventful cataract surgery implanting AU00T0 IOLs. Data from one eye per patient were randomly included. Eyes with a corrected distance visual acuity worse than 0.1 logMAR were excluded. IOLCON-optimized constants were used for all formulas other than the Castrop formula. The outcome measures were prediction error (PE) and absolute prediction error (absPE) for the 6 study formulas. RESULTS 251 eyes from 251 patients were assessed. Excluding lens thickness led to statistically significant differences in absPE in several formulas. Leaving out horizontal corneal diameter did not impact absPE in several formulas. Differences in PE offset were observed between the various formula variations. CONCLUSIONS When using multivariate formulas with an A-constant, including certain optional parameters is vital for optimal refractive results. Formula variations excluding certain biometric parameters need specifically optimized constants and do not perform similarly when using the constant of the respective formula using all parameters.
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Affiliation(s)
- Jascha A Wendelstein
- From the Institut für Refraktive und Ophthalmochirurgie (IROC), Zurich, Switzerland (Wendelstein, Seiler); Department for Ophthalmology and Optometry, Kepler University Hospital GmbH, Linz, Austria (Wendelstein); Johannes Kepler University Linz, Medical Faculty, Linz, Austria (Wendelstein, Rothbächer); Institute of Experimental Ophthalmology, Saarland University, Homburg, Germany (Wendelstein, Langenbucher); Dean A. McGee Eye Institute/University of Oklahoma, Oklahoma City, Oklahoma (Heath, McDonald, Riaz); Augen-und Laserklinik, Castrop-Rauxel, Germany (Hoffmann); Great Lakes Eye Care, Saint Joseph, Michigan (Cooke); Department of Neurology and Ophthalmology, Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan (Cooke)
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Tao Y, Li M, Tan J, Huang J, Cheng X, Xie P, Liu X, Zhou Q, Ouyang J. Effects of atropine and tropicamide on ocular biological parameters in children: a prospective observational study. BMC Ophthalmol 2023; 23:96. [PMID: 36915059 PMCID: PMC10010000 DOI: 10.1186/s12886-023-02840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/03/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND The effectiveness of cycloplegia in delaying the progression of myopia and its application in refractive examination in children have been extensively studied, but there are still few studies on the effects of atropine/tropicamide on ocular biological parameters. Therefore, the purpose of this study was to explore the effects of atropine/tropicamide on children's ocular biological parameters in different age groups and the differences between them. METHODS This was a prospective observational study in which all school children were examined for dioptres and ocular biological parameters in the outpatient clinic, and 1% atropine or tropicamide was used for treatment. After examination, we enrolled the patients grouped by age (age from 2 to 12 years treated by atropine, 55 cases; age from 2 to 10 years treated by tropicamide, 70 cases; age from 14 to 17 years treated by tropicamide, 70 cases). The ocular biological parameters of each patient before and after cycloplegia were measured, and the difference and its absolute value were calculated for statistical analysis using an independent-samples t test. RESULTS We compared the value and the absolute value of the differences in ocular biological parameters before and after cycloplegia in the same age group, and we found that the differences were not statistically significant (P > 0.05). There were significant differences in the corresponding values of AL, K1 and ACD among the different age groups (P < 0.05). Before cycloplegia, there were significant differences in AL, K, K1, K2 and ACD in different age groups (P < 0.05). However, the differences in AL, K, K1, K2 and ACD among different age groups disappeared after cycloplegia (P > 0.05). CONCLUSIONS This study demonstrated that atropine/tropicamide have different effects on cycloplegia in children of different ages. The effects of atropine/tropicamide on ocular biological parameters should be fully considered when evaluating the refractive state before refractive surgery or mydriasis optometry for children of different ages.
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Affiliation(s)
- Yulin Tao
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China.,Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, 17 Yongwai Main Street, Nanchang, 330006, Jiangxi, China
| | - Mohan Li
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, No.678 Furong Road, Economic Development Zone, Hefei, 230031, Anhui, China
| | - Jian Tan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, 17 Yongwai Main Street, Nanchang, 330006, Jiangxi, China
| | - Jing Huang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, 17 Yongwai Main Street, Nanchang, 330006, Jiangxi, China
| | - Xiaokang Cheng
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China
| | - Ping Xie
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China
| | - Xiansheng Liu
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China
| | - Qiong Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Center of National Ocular Disease Clinical Research Center, 17 Yongwai Main Street, Nanchang, 330006, Jiangxi, China.
| | - Jun Ouyang
- Department of Ophthalmology, Jiujiang No 1 Peoples Hospital, Affiliated Jiujiang Hospital of Nanchang University, 48 South Taling Road, Jiujiang, 332000, Jiangxi, China.
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Changes in ocular biological parameters after cycloplegia based on dioptre, age and sex. Sci Rep 2022; 12:22470. [PMID: 36577765 PMCID: PMC9797549 DOI: 10.1038/s41598-022-25462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022] Open
Abstract
The effects of cycloplegia on ocular biological parameters in children have been extensively studied, but few studies have compared these parameters between different refractive states, ages, and sexes. Therefore, the purpose of this study was to investigate the changes in ocular biometry before and after cycloplegia in different groups based on dioptre, age and sex. We examined a total of 2049 participants in this cross-sectional study. A comprehensive eye examination was conducted before cycloplegia. Cycloplegia was implemented with the application of atropine or tropicamide. Ocular biological parameters were evaluated after cycloplegia, including axial length (AL), mean keratometry (K), flat keratometry (K1), steep keratometry (K2), central corneal thickness (CCT), anterior chamber depth (ACD) and white-to-white (WTW) distance. All the participants were categorized based on dioptre, age and sex. Statistical analysis was performed with paired t tests and Wilcoxon signed-rank tests. Regarding dioptre, AL was found to be increased significantly in the Fs, Ast and FA (p < 0.05) postcycloplegia groups. We observed significant increases in K, K1, K2 and ACD in the Fs group (p < 0.05) after cycloplegia. Regarding age, we found significant increases in AL, CCT and ACD in group 1 (p < 0.05), but AL decreased significantly in groups 2 and 3 (p < 0.05) postcycloplegia. There were no significant changes found in K, K1 and K2 in the three groups after cycloplegia (p > 0.05). Regarding sex, AL and WTW were found to decrease significantly among males and increase significantly among females (p < 0.05) postcycloplegia, while K, K1 and K2 showed the opposite trends. This study showed that there were differences in some ocular biological parameters after cycloplegia across different groups; in particular, there were significant differences in AL, CCT and ACD. Attention should be devoted to the influence of cycloplegia in clinical work.
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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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Lin CY, Wang I, Lin CJ, Lai CT, Bair H, Chen WL, Lin JM, Tien PT, Hsia NY, Tsai YY. Short-term anatomic response of the choroid to tropicamide in myopic patients. Medicine (Baltimore) 2022; 101:e30481. [PMID: 36123905 PMCID: PMC9478313 DOI: 10.1097/md.0000000000030481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We aimed to investigate how tropicamide alters subfoveal choroidal thickness (SFChT) and choriocapillaris flow density (CD) and determine the predictive factors of choroid thickness and vascular density in myopic eyes. This retrospective study was conducted from September 2018 to March 2019. SFChT was measured with enhanced depth spectrum-domain optical coherence tomography. The choriocapillaris was imaged using optical coherence tomography angiograms. Ocular parameters were measured thirty minutes before and after 1% tropicamide instillation. Twenty-five eyes of 15 patients (mean age 38.12 ± 6.35 years old and refractive error-8.57 ± 3.37 D) met the study criteria. The baseline linear regression model showed an association of thinner choroid with older age (P = .027) and high myopic patients (P = .001). Tropicamide substantially increased SFChT (P = .001), but had no significant influence on CD (P = .526). Moreover, SFChT variation after tropicamide instillation positively correlated with diopter changes in spherical equivalent (P = .005) and percentage changes in CD (P = .046). In myopic eyes, choroidal layer thickened substantially in response to tropicamide. The increase of SFChT only correlates with variations in spherical equivalent and CD. Short-term tropicamide installation altered both choroid thickness and choroid microvasculature, which implies an interplay among choroidal volume, perfusion, and ciliary muscle tone.
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Affiliation(s)
- Chih-Ying Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - I. Wang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ju Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| | - Chun-Ting Lai
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
- * Correspondence: Chun-Ting Lai, Department of Ophthalmology, China Medical University Hospital, No. 2 Yu-Der Road, Taichung 404, Taiwan (e-mail: )
| | - Henry Bair
- School of Medicine, Stanford University, United States of America
| | - Wen-Lu Chen
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Jane-Ming Lin
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Peng-Tai Tien
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Ning-Yi Hsia
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Yu Tsai
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Ophthalmology, Eye Center, China Medical University Hospital, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
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Ouchi M. Evaluation of impact of posterior phakic IOL implantation on biometry and effectiveness of concomitant use of anterior segment OCT on IOL power calculation for cataract surgery. J Cataract Refract Surg 2022; 48:657-662. [PMID: 34486576 PMCID: PMC9119396 DOI: 10.1097/j.jcrs.0000000000000811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the effects of phakic intraocular lens (pIOL) implantation on the intraocular lens (IOL) power calculation and subsequently to evaluate the effectiveness of concomitant use of anterior segment optical coherence tomography (AS-OCT) against biometric changes. SETTING Masayuki Ouchi Eye Clinic, Kyoto, Japan. DESIGN Prospective consecutive case series. METHODS 100 patients (100 eyes) who underwent pIOL implantation were enrolled. In each eye, biometry was performed using partial coherence interferometry (PCI) and AS-OCT. Pre-pIOL and post-pIOL implantation IOL power calculation using SRK/T (S), Haigis (H), and Barret Universal II (B) formulas was compared. RESULTS 100 patients (100 eyes) were included. Anterior chamber depth (ACD) was significantly shorter at post-pIOL implantation for both PCI (P < .001) and AS-OCT (P = .05). When using PCI, the crystalline lens surface was misidentified in 75% of eyes, and in these eyes, the ACD difference between pre-pIOL and post-pIOL implantation exceeded that with both PCI and AS-OCT. The estimated IOL power was significantly lower at post-pIOL implantation according to the H and B formulas (both P < .001) but remained unchanged by the S formula. However, no difference was observed when AS-OCT-derived ACD and lens thickness (LT) values were introduced in the H (P = .16) and B (P = .55) formulas. CONCLUSIONS Misidentification of the lens surface occurs in many pIOL-implanted eyes with PCI measurements and could influence the power calculation with H and B formulas while leaving the S formula unaffected. AS-OCT-derived ACD and LT value substitution is recommended for H and B formulas.
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Kumcu ND, Balikoglu-Yilmaz M, Ozgul S, Imre SS. Anterior Segment Parameters after Uveitic Cataract Surgery: A Prospective Study with 1-Year Results. Photodiagnosis Photodyn Ther 2022; 37:102736. [DOI: 10.1016/j.pdpdt.2022.102736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/16/2022] [Accepted: 01/18/2022] [Indexed: 11/29/2022]
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Autrata D, Chrapek O, Drahorád S. EFFECT OF PHARMACOLOGICAL PUPIL DILATION ON INTRAOCULAR LENS POWER CALCULATION IN PATIENTS INDICATED FOR CATARACT SURGERY. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2021; 77:192-200. [PMID: 34507495 DOI: 10.31348/2021/22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the influence of pupil dilation on ocular parameters measured by optical biometry and the influence of pupil dilation on intraocular lens (PC IOL) power calculation by using the third-generation (SRK/T) and the fourth-generation (Haigis) formula. METHODS 40 eyes of patients indicated for cataract surgery were included in this study. Each patient was examined by optical biometer firstly without artificial mydriasis (AM) and then after AM, which was achieved using local application of short-term acting mydriatics. Biometric data were measured by Lenstar LS 900 optical biometer, we recorded axial length of the eye (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and corneal astigmatism and optical power of cornea. These data we measured were used for calculation of the PC IOL optical power using both the SRK/T and the Haigis formula. The target postoperative refraction was set to emmetropia. Statistical analysis was performed for evaluation of influence of AM on each ocular parameter and influence of AM on the recommended PC IOL power calculated by the SRK/T and the Haigis formula. RESULTS No statistically significant effect of AM on AL, LT and keratometry was demonstrated. On the contrary we demonstrated significant effect on CCT and ACD. No effect of AM on the PC IOL power calculation using the SRK/T formula was proved - the PC IOL optical power before AM and after AM did not differ in any case. When using the Haigis formula for the PC IOL power calculation, the recommended optical power of the PC IOL changed by +0.5 Dpt in 9 eyes, i.e., 22.5 % of the whole group, but statistical analysis did not show this change as statistically significant. CONCLUSION Pharmacological dilation of the pupil significantly affects some intraocular parameters measured by optical biometer and in the case of using the Haigis formula it can influence recommended power of the PC IOL. Conversely, when using the SRK/T formula, pharmacological dilation of pupil does not affect the recommended PC IOL power.
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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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Teshigawara T, Meguro A, Mizuki N. A Comparison Between Monofocal and Multifocal Intraocular Lenses in the Influence of Pupil Dilation on Target Postoperative Refraction. Asia Pac J Ophthalmol (Phila) 2020; 9:420-425. [PMID: 32804711 DOI: 10.1097/apo.0000000000000310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The aim of this study was to compare the influence of pupil dilation on power calculation formulas for third- (Hoffer Q, SRK/T) and fourth- (Haigis, Holladay3) generation intraocular lens (IOL) between monofocal and multifocal IOLs. DESIGN Retrospective, comparative study. METHODS We analyzed 280 eyes (162 monofocal, 118 multifocal; mean patient age: 72.9 ± 7.7 years; 41.25% male). Anterior chamber depth (ACD) and lens thickness (LT) were measured. Predicted postoperative refraction (PPR) and recommended IOL power were calculated using third- and fourth-generation formulas pre- and post-dilation. We evaluated the mean absolute change (MAC) in PPR, change in recommended IOL power per formula, and mean change in ACD and LT between pre- and post-dilation, for both monofocal and multifocal IOLs. RESULTS ACD and LT showed significant changes post-dilation. The MAC in PPR was significantly higher with fourth-generation formulas than that with third-generation formulas, for both IOLs, and more so for multifocal IOLs. For both IOLs, the PPR change correlated positively with ACD changes, but negatively with LT changes, for fourth-generation formulas. Multifocals correlated significantly stronger with LT than monofocals. When using fourth-generation formulas post-dilation, the recommended IOL power changed more frequently in multifocals than in monofocals, although not significantly. CONCLUSIONS Pupil dilation did not influence third-generation formula calculations for both IOL types, but did affect PPR and recommended IOL power when using fourth-generation formulas, and more so for multifocals. Considering pupil dilation effects on monofocal and multifocal parameters is vital for accurate IOL calculation.
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Affiliation(s)
- Takeshi Teshigawara
- Yokosuka Choo Eye Clinic, Yokosuka, Kanagawa, Japan
- 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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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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Reliability of a New Swept-Source Optical Coherence Tomography Biometer in Healthy Children, Adults, and Cataract Patients. J Ophthalmol 2020; 2020:8946364. [PMID: 32509343 PMCID: PMC7246393 DOI: 10.1155/2020/8946364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/04/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose To comprehensively assess the reliability of a new optical biometer (IOLMaster 700), based on swept-source optical coherence tomography (SS-OCT) and comparison with a standard biometer (IOLMaster 500), in healthy children, adults, and cataract patients. Methods A total of 301 eyes from 301 consecutive subjects were enrolled prospectively. Two experienced operators measured each eye three times consecutively with the IOLMaster 700. The axial length (AL), keratometry (K), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness (CCT), and white-to-white (WTW) distance were recorded. Intraoperator repeatability and interoperator reproducibility of the IOLMaster 700 were analyzed using the test-retest (TRT), coefficients of variation (CoV), and intraclass correlation coefficients (ICCs). The agreement between the two devices was evaluated using the Bland–Altman method. Results The repeatability and reproducibility of the SS-OCT optical biometer were high for all ocular biometry parameters in all groups, except for the WTW in cataract patients (TRT, 0.27–0.44 mm; ICC, 0.86–0.95). The reproducibility of averaged measurements from three consecutive readings (TRT : AL = 0.02 mm, CCT = 5.41 μm, ACD = 0.03 mm, LT = 0.03 mm, Km = 0.17 D, and WTW = 0.22 mm) was higher than the reproducibility of single measurements (TRT : AL = 0.04 mm, CCT = 7.43 μm, ACD = 0.06 mm, LT = 0.05 mm, Km = 0.26 D, and WTW = 0.35 mm) in the three groups. The consistency in the data between the two biometers was high, with narrow 95% LoAs in the three groups. Conclusion Repeatability and reproducibility of the new SS-OCT optical biometer were excellent and consistent with that of the standard biometer with respect to healthy children, healthy adults, and cataract patients.
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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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Anterior chamber depth and iris and lens position before and after phacoemulsification in eyes with a short or long axial length. J Cataract Refract Surg 2018; 42:563-8. [PMID: 27113879 DOI: 10.1016/j.jcrs.2015.12.050] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/22/2015] [Accepted: 12/28/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate changes in anterior segment parameters after phacoemulsification in short eyes and long eyes. SETTING Spektrum Eye Clinic, Wrocław, Poland. DESIGN Prospective comparative study. METHODS Anterior segment parameters were examined before and after phacoemulsification in 3 groups of eyes as follows: short (axial length [AL] <22.0 mm), normal (AL 22.5 to 25.0 mm), and long (AL> 25.5 mm) with optical biometry based on partial coherence interferometry (IOLMaster) and anterior segment optical coherence tomography (Visante). RESULTS The study comprised 20 short eyes, 22 normal eyes, and 19 long eyes. The anterior chamber angle increased after surgery in all eyes (P < .05). The relative change in anterior chamber depth (ACD) was larger in short eyes (57%) than in normal eyes (44%) or long eyes (42%) (P < .017). The change in iris position after phacoemulsification was larger in short eyes than in normal or long eyes (mean change 0.93 mm, 0.70 mm, and 0.43 mm, respectively) (P < .017). The change in lens position after phacoemulsification in relation to the iris was smaller in short eyes (mean 0.51 mm) than in normal or long eyes (mean 0.82 mm and 1.10 mm, respectively) (P < .017). CONCLUSIONS The relative change in ACD after phacoemulsification was larger in short eyes than in normal eyes and long eyes. The largest change in iris position occurred in short eyes. The largest change in the lens versus the intraocular lens (IOL) position occurred in long eyes, with the IOL moving back from the iris. Optical biometry might underestimate the postoperative ACD. FINANCIAL DISCLOSURE Neither author has a financial or proprietary interest in any material or method mentioned.
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Teshigawara T, Meguro A, Mizuki N. Influence of pupil dilation on predicted postoperative refraction and recommended IOL to obtain target postoperative refraction calculated by using third- and fourth-generation calculation formulas. Clin Ophthalmol 2018; 12:1913-1919. [PMID: 30323547 PMCID: PMC6174306 DOI: 10.2147/opth.s172846] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose To evaluate the influence of pupil dilation on predicted postoperative refraction (PPR) and recommended intraocular lens (IOL) power to obtain target postoperative refraction calculated by using the third- and fourth-generation IOL power calculation formulas with a new optical biometer. Methods This retrospective study included 162 eyes with cataract that underwent uneventful phacoemulsification with IOL implantation. PPR, recommended IOL power, anterior chamber depth (ACD), and lens thickness (LT) were measured pre- and post-pupil dilation. The change in PPR detected by using third-generation (Hoffer Q and SRK/T) and fourth-generation formulas (Haigis and Holladay 2) and the changes in ACD and LT were evaluated pre- and postdilation. The influence of dilation on the recommended IOL power calculated by each formula was analyzed. Result ACD and LT significantly changed from pre- to postdilation. The mean absolute change in PPR between pre- and postdilation was significantly higher for fourth-generation formulas compared with third-generation formulas. The change in PPR between pre- and postdilation showed a significantly positive correlation with change in ACD and a significantly negative correlation with change in LT with fourth-generation formulas, but not with third-generation formulas. The discrepancy rate of recommended IOL power between pre- and postdilation calculated by fourth-generation formulas was significantly higher than that calculated by third-generation formulas. Conclusion ACD and LT significantly changed by dilation. PPR and recommended IOL power significantly changed more by dilation when using fourth-generation formulas compared with third-generation formulas. Given the significant correlations of the change in PPR (between the pre- and postdilation) in the fourth-generation formulas and the changes in ACD and LT, the latter changes may be key in influencing dilation in the fourth-generation power calculation. Knowledge of the influence of dilation on fourth-generation formulas could help improve IOL calculation.
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Affiliation(s)
- Takeshi Teshigawara
- Yokosuka Chuoh Eye Clinic, Yokosuka, Kanagawa, Japan, .,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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Raina UK, Gupta SK, Gupta A, Goray A, Saini V. Effect of Cycloplegia on Optical Biometry in Pediatric Eyes. J Pediatr Ophthalmol Strabismus 2018; 55:260-265. [PMID: 29809268 DOI: 10.3928/01913913-20180327-05] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/19/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To study the effect of cycloplegia on optical biometry parameters in pediatric eyes using the Lenstar LS 900 (Haag-Streit, Koeniz, Switzerland). METHODS In this observational and comparative study, 56 normal eyes and 20 cataractous eyes in children between 5 and 15 years of age were included. Measurements were taken before and after cycloplegia using 2% homatropine drops. Parameters studied were axial length, central corneal thickness, keratometry, anterior chamber depth, and lens thickness. The Wilcoxon test was used to compare the effects of cycloplegia on all parameters. RESULTS Cycloplegia resulted in a statistically significant decrease in axial length (P < .05), central corneal thickness (P < .05), and lens thickness (P < .001) and an increase in the anterior chamber depth (P < .001) in normal eyes. In the cataract group, cycloplegia resulted in an increase in anterior chamber depth (P < .001) and decrease in lens thickness (P < .001). CONCLUSIONS Biometry measurements have to be carefully interpreted in pediatric eyes where cycloplegia is an important part of the examination. [J Pediatr Ophthalmol Strabismus. 2018;55(4):260-265.].
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Lundberg K, Vestergaard AH, Jacobsen N, Suhr Thykjaer A, Søgaard Hansen R, Goldschmidt E, Peto T, Halekoh U, Wedderkopp N, Grauslund J. Choroidal thickness and myopia in relation to physical activity - the CHAMPS Eye Study. Acta Ophthalmol 2018; 96:371-378. [PMID: 29338123 DOI: 10.1111/aos.13640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/17/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE To describe the relationship between choroidal thickness (CT) and myopia in relation to physical activity (PA) in a population-based child cohort. METHODS In a prospective study of 307 children from the CHAMPS Study Denmark, we used objective data from GT3X accelerometer worn at four periods between 2009 and 2015 to determine the amount and intensity of PA. Intensity was estimated as counts/minutes, and cut-off points were defined at four intensity levels. Eye examinations were performed in 2015 and included autorefraction in cycloplegia, axial length (AL) by biometric and fovea-centred enhanced depth imaging optical coherence tomography. By a semi-automated method, we measured the CT at 17 targets per eye representing anatomically different locations (subfoveal, 1 and 3 millimetre in each direction of fovea). RESULTS Mean age at the eye examination was 15.4 ± 0.7 years. The mean AL was 23.5 ± 0.9 mm, and the mean subfoveal CT was 369 ± 87 μm. Choroidal thickness (CT) was 331 ± 68 μm for the overall macula, 355 ± 78 μm for the 1-mm zone and 304 ± 60 μm for the 3-mm zone. All CT measurements were thinner in myopic eyes (p < 0.0001) and in boys (p < 0.05). We found no association between total PA and the CT by either mixed model analysis (p = 0.074) or linear regression by any intensity levels (p = 0.22, p = 0.15 and p = 0.43). CONCLUSION Among adolescents aged 14-17 years, there was no association between objective PA exposures and the CT, AL or refractive error.
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Affiliation(s)
- Kristian Lundberg
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
| | - Anders Højslet Vestergaard
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
| | - Nina Jacobsen
- Department of Ophthalmology; Rigshospitalet-Glostrup University Hospital; Copenhagen Denmark
| | - Anne Suhr Thykjaer
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
| | - Rasmus Søgaard Hansen
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
| | | | - Tunde Peto
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
- Centre for Public Health; Queen's University Belfast; Belfast UK
| | - Ulrich Halekoh
- Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - Niels Wedderkopp
- Centre of Research in Childhood Health; Research Unit for Exercise Epidemiology; Department of Sports Science and Clinical Biomechanics; University of Southern Denmark; Odense Denmark
- Sport medicine Clinic; The Orthopedic Department; Hospital of Middelfart; Institute of Regional Health Services Research; University of Southern Denmark; Middelfart Denmark
| | - Jakob Grauslund
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
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Zhang Y, Jin G, Young CA, Cao Q, Lin J, Lin J, Wang Y, Zheng D. Analysis of Corneal Astigmatism before Surgery in Chinese Congenital Ectopia Lentis Patients. Curr Eye Res 2018; 43:972-976. [DOI: 10.1080/02713683.2018.1470248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Yichi Zhang
- Department of Ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | - Qianzhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Junxiong Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jianqiang Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yiyao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Bagheri A, Feizi M, Shafii A, Faramarzi A, Tavakoli M, Yazdani S. Effect of Cycloplegia on Corneal Biometrics and Refractive State. J Ophthalmic Vis Res 2018; 13:101-109. [PMID: 29719636 PMCID: PMC5905301 DOI: 10.4103/jovr.jovr_196_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To determine changes in refractive state and corneal parameters after cycloplegia with cyclopentolate hydrochloride 1% using a dual Scheimpflug imaging system. Methods In this prospective cross-sectional study patients aged 10 to 40 years who were referred for optometric evaluation enrolled and underwent autorefraction and corneal imaging with the Galilei dual Scheimpflug system before and 30 minutes after twice instillation of medication. Changes in refraction and astigmatism were investigated. Corneal biometrics including anterior and posterior corneal curvatures, total corneal power and corneal pachymetry were compared before and after cycloplegia. Results Two hundred and twelve eyes of 106 subjects with mean age of 28 ± 5 years including 201 myopic and 11 hyperopic eyes were evaluated. Mean spherical equivalent refractive error before cycloplegia was -3.4 ± 2.6 D. A mean hyperopic shift of 0.4 ± 0.5 D occurred after cycloplegia (P < 0.001). The astigmatism power did not significantly change (P = 0.8), however, 26.8% of eyes with significant astigmatism experienced a change of more than 5 degrees in the axis of astigmatism. Changes in posterior corneal curvature were scant but statistically significant (P = 0.001). Moreover, corneal thickness was slightly increased in the central and paracentral regions (P < 0.001 and P < 0.001, respectively). Conclusion Cycloplegia causes a hyperopic shift and astigmatism axis changes, along with an increase in central and paracentral corneal thickness and change in posterior corneal curvature. The effects of cycloplegia on refraction and corneal biometrics should be considered before cataract and refractive surgeries.
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Affiliation(s)
- Abbas Bagheri
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Feizi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aliakbar Shafii
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Faramarzi
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Tavakoli
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahin Yazdani
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wu Y, Liu S, Liao R. Prediction accuracy of intraocular lens power calculation methods after laser refractive surgery. BMC Ophthalmol 2017; 17:44. [PMID: 28390411 PMCID: PMC5385019 DOI: 10.1186/s12886-017-0439-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 04/05/2017] [Indexed: 11/14/2022] Open
Abstract
Background This study aimed to evaluate the prediction accuracy of postoperative refractions using partial coherence interferometry (IOL-Master) and applanation ultrasound (AL-3000) assisted with corneal topography (TMS-4) in eyes that had undergone myopic laser-assisted in situ keratomileusis (LASIK). Methods Haigis-L formula, Koch–Maloney method using Haigis formula, Shammas clinically derived K-value (simulated keratometric value) correction (Shammas c.d.) using Haigis formula, and Shammas post-LASIK (Shammas-PL) formula were used in eyes with myopic LASIK. Constants were derived from the optimized constants in 133 virgin eyes. Refractive outcomes were determined by streak retinoscopy and subjective manifest refraction. Methods and formulas were evaluated by mean error (ME), standard deviation (SD), range of error, mean absolute error (MAE), median absolute error, 95% confidence interval of MAE, and percentage of eyes within ±0.5 diopter (D), ±1.0 D, and ±1.5 D of prediction. Results SDs of the Haigis-L, Koch-Maloney method using the Haigis formula, Shammas c.d. using the Haigis formula, and the Shammas-PL formula using IOL-Master were 0.721, 0.695, 0.695, and 0.698; and those using AL-3000 assisted with TMS-4 were 0.782, 0.741, 0.743, and 0.778, respectively. Conclusions No-history methods that corrected corneal power with measurements using IOL-Master were promising in myopic post-LASIK eyes, but still a gap in prediction accuracy exists between virgin eyes and post-LASIK eyes. Electronic supplementary material The online version of this article (doi:10.1186/s12886-017-0439-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yubo Wu
- Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, Anhui, 230022, China
| | - Songyu Liu
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, Anhui, 230022, China
| | - Rongfeng Liao
- Department of Ophthalmology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, Anhui, 230022, China.
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Özyol P, Özyol E, Baldemir E. Changes in Ocular Parameters and Intraocular Lens Powers in Aging Cycloplegic Eyes. Am J Ophthalmol 2017; 173:76-83. [PMID: 27702623 DOI: 10.1016/j.ajo.2016.09.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 09/25/2016] [Accepted: 09/25/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Age-related changes in lens elasticity and ciliary muscle contractility can affect how ocular parameters respond to cycloplegia, and therefore intraocular lens (IOL) power measurements calculated by formulas using anterior chamber depth (ACD), lens thickness (LT), or white-to-white (WtW) for effective lens position prediction can vary. In response, using swept-source optical biometry in prepresbyopic and presbyopic eyes, we investigated changes in ocular parameters and IOL power calculations attributable to cycloplegia. DESIGN Cross-sectional study. METHODS In 38 prepresbyopic and 42 presbyopic eyes, we measured pupil diameter, radius of corneal curvature values, central corneal thickness, WtW, ACD, LT, and axial length both before and after cycloplegia. We determined IOL power calculations with the Sanders-Retzlaff-Kraff/theoretical, Holladay 2, and Haigis formulas. To pinpoint the effect of cycloplegia, we recorded refractive predictions in pre- and postdilation conditions according to the same IOL power calculations, even if postdilation IOL power calculations had changed. RESULTS With cycloplegia, pupil diameter changed significantly more in presbyopic eyes (P < .001). Central corneal thickness decreased in prepresbyopic eyes (P = .048), whereas WtW increased in presbyopic eyes (P = .02). In both groups, ACD and LT changed significantly (P < .001). IOL power calculations according to the Holladay 2 formula differed in prepresbyopic eyes (P = .042), and refractive predictions with the Holladay 2 and Haigis formulas differed significantly in prepresbyopic eyes (P = .043 and P = .022, respectively). CONCLUSION Surgeons should consider the effect of cycloplegia on refractive prediction errors and IOL power calculations determined with Haigis and Holladay 2 formulas, especially in prepresbyopic ages.
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Arriola-Villalobos P, Almendral-Gómez J, Garzón N, Ruiz-Medrano J, Fernández-Pérez C, Martínez-de-la-Casa JM, Díaz-Valle D. Effect of pharmacological pupil dilation on measurements and iol power calculation made using the new swept-source optical coherence tomography-based optical biometer. J Fr Ophtalmol 2016; 39:859-865. [PMID: 27793471 DOI: 10.1016/j.jfo.2016.09.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/29/2016] [Accepted: 09/02/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To determine whether pupil dilation affects biometric measurements and intraocular lens (IOL) power calculation made using the new swept-source optical coherence tomography-based optical biometer (IOLMaster 700©; Carl Zeiss Meditec, Jena, Germany). PROCEDURES Eighty-one eyes of 81 patients evaluated for cataract surgery were prospectively examined using the IOLMaster 700© before and after pupil dilation with tropicamide 1%. The measurements made were: axial length (AL), central corneal thickness (CCT), aqueous chamber depth (ACD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW) and pupil diameter (PD). Holladay II and SRK/T formulas were used to calculate IOL power. Agreement between measurement modes (with and without dilation) was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS Mean patient age was 75.17±7.54 years (range: 57-92). Of the variables determined, CCT, ACD, LT and WTW varied significantly according to pupil dilation. Excellent intraobserver correlation was observed between measurements made before and after pupil dilation. Mean IOL power calculation using the Holladay 2 and SRK/T formulas were unmodified by pupil dilation. CONCLUSIONS The use of pupil dilation produces statistical yet not clinically significant differences in some IOLMaster 700© measurements. However, it does not affect mean IOL power calculation.
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Affiliation(s)
- P Arriola-Villalobos
- Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle del Prof. Martín Lagos, s/n, 28040 Madrid, Spain
| | - J Almendral-Gómez
- Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle del Prof. Martín Lagos, s/n, 28040 Madrid, Spain.
| | - N Garzón
- Instituto de Oftalmología Avanzada, 28010 Madrid, Spain
| | - J Ruiz-Medrano
- Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Calle del Prof. Martín Lagos, s/n, 28040 Madrid, Spain
| | - C Fernández-Pérez
- Investigative Support Unit, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28010 Madrid, Spain
| | - J M Martínez-de-la-Casa
- Ophthalmology, Hospital Clínico San Carlos, Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28010 Madrid, Spain
| | - D Díaz-Valle
- Ophthalmology, Hospital Clínico San Carlos, Departamento de Oftalmología y ORL, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28010 Madrid, Spain
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Khambhiphant B, Sasiwilasagorn S, Chatbunchachai N, Pongpirul K. Effect of pupillary dilation on Haigis formula-calculated intraocular lens power measurement by using optical biometry. Clin Ophthalmol 2016; 10:1405-10. [PMID: 27555746 PMCID: PMC4968869 DOI: 10.2147/opth.s109797] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the effect of pupillary dilation on the Haigis formula-calculated intraocular lens (IOL) power and ocular biometry measurements by using IOLMaster(®). METHODS A prospective study was performed for biometry measurements of 373 eyes of 192 healthy subjects using the IOLMaster at the outpatient department of King Chulalongkorn Memorial Hospital from February 2013 to July 2013. The axial length (AL), anterior chamber depth (ACD), keratometry (K), and IOL power were measured before and after 1% tropicamide eye drop instillation. The Haigis formula was used in the IOL power calculation with the predicted target to emmetropia. Each parameter was compared by a paired t-test prior to and after pupillary dilation. Bland-Altman plots were also used to determine the agreement between each parameter. RESULTS The mean age of the subjects was 53.74±14.41 years (range 18-93 years). No differences in AL (P=0.03), steepest K (P=0.42), and flattest K (P=0.41) were obtained from the IOLMaster after pupillary dilation. However, ACD and IOL power were significantly different postdilation (P<0.01 and P<0.01, respectively). In ACD and IOL power measurements, the concordance rates were 93.03% and 97.05% within 95% limits of agreement (-0.48 to 0.26 mm and -1.09 to 0.88 D, respectively) in the Bland-Altman plots. CONCLUSION Biometry measurements in the cycloplegic stage should be considered in the IOL formulas that use parameters other than AL and K.
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Affiliation(s)
- Bharkbhum Khambhiphant
- Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Thai Red Cross Society
| | | | | | - Krit Pongpirul
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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