Influence of cycloplegia with topical cyclopentolate on higher-order aberrations in myopic children

Abstract

Purpose To investigate the influence of cycloplegia with topical cyclopentolate on wavefront aberrations in myopic children. Design This is a prospective, comparative study. Methods Twenty-eight myopic children with a mean age of 7.25±2.55 were enrolled in this study. We evaluated refraction and wavefront aberrations before and after cycloplegia with 1% cyclopentolate hydrochloride. Ocular and corneal aberrations were simultaneously measured and compared with each other. Individual Zernike components were also analyzed up to the sixth order. All these parameters were compared before and after cycloplegia. Results Ocular higher-order aberrations (HOAs) significantly increased after cycloplegia (P ¼ 0.012 for spherical-like and P ¼ 0.015 for total HOAs). Corneal HOAs did not change after cycloplegia. When corneal and ocular HOAs were compared, the ocular HOAs were significantly smaller than the corneal HOAs in spherical-like aberrations (Po0.001) and total HOAs (P ¼ 0.006). As for individual Zernike components, ocular aberration generally showed smaller or equivalent values in comparison with corneal aberration. In addition, each Zernike component showed a large standard deviation. Conclusions Internal optics compensates for corneal HOAs in myopic children, and paralysis of tonic accommodation with cyclopentolate considerably affects ocular HOAs. However, inter-individual variation in each Zernike component is quite large in myopic children.

Effect of cycloplegia on the measurement of refractive error in Chinese children

“…In addition, spherical aberration might be responsible for the negative change of M. Spherical aberration significantly increased after cycloplegia, which was negatively correlated with axial myopia . Gao et al reported that cycloplegia induced significant decreases in the lens thickness and backward movement of the lens, which increased the spherical aberration.…”

Comparison of noncycloplegic and cycloplegic autorefraction in categorizing refractive error data in children

“…For example, refraction across a larger pupil aperture during cycloplegia may be influenced by the peripheral aberrations induced by refractive media (Hiraoka et al. ). Also with cycloplegia, differences in outcome exist with the amount and type of cycloplegic agent used and in pigmented versus nonpigmented eyes; thus, there is no single reliably consistent measure.…”

Higher order aberrations, refractive error development and myopia control: a review

“…The effect of other concentrations of atropine on HOAs have not been examined, although similar findings have been demonstrated following the instillation of other topical anti‐muscarinic agents. In similarly aged myopic children, an increase in HOA and spherical‐like RMS of 0.025 and 0.014 μm for a 6 mm pupil, respectively, was observed following the instillation of 1% cyclopentolate eye drops . Additionally, a positive shift in ocular primary spherical aberration () occurred coincidentally with a 0.50 D hyperopic shift, but these changes were of smaller magnitude compared to atropine and there was no change observed in coma‐like RMS or primary horizontal coma () .…”

“…In similarly aged myopic children, an increase in HOA and spherical-like RMS of 0.025 and 0.014 μm for a 6 mm pupil, respectively, was observed following the instillation of 1% cyclopentolate eye drops. 154 Additionally, a positive shift in ocular primary spherical aberration (Z 0 4 ) occurred coincidentally with a 0.50 D hyperopic shift, but these changes were of smaller magnitude compared to atropine and there was no change observed in coma-like RMS or primary horizontal coma (Z 1 3 ). 154 Interestingly, 0.5% tropicamide eye drops produced a small increase of 0.017 μm in total coma but negligible changes in HOA and spherical aberration RMS; 155 however, given the postinstillation interval prior to measurement was only five minutes in this study, the full manifestation of optical changes may not have been observed since maximal cycloplegia due to tropicamide occurs approximately 20 minutes post-instillation.…”

“…154 Additionally, a positive shift in ocular primary spherical aberration (Z 0 4 ) occurred coincidentally with a 0.50 D hyperopic shift, but these changes were of smaller magnitude compared to atropine and there was no change observed in coma-like RMS or primary horizontal coma (Z 1 3 ). 154 Interestingly, 0.5% tropicamide eye drops produced a small increase of 0.017 μm in total coma but negligible changes in HOA and spherical aberration RMS; 155 however, given the postinstillation interval prior to measurement was only five minutes in this study, the full manifestation of optical changes may not have been observed since maximal cycloplegia due to tropicamide occurs approximately 20 minutes post-instillation. 148 One per cent cyclopentolate and 0.5% tropicamide have been shown to have some 156 and negligible 157 effect in slowing myopia progression, respectively.…”