Short-Term Refractive Change and Ocular Parameter Changes after Cycloplegia

Cheng, Han-Chih; Hsieh, Yi‐Ting

doi:10.1097/opx.0000000000000339

Cited by 33 publications

(56 citation statements)

References 28 publications

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“…Previous studies that examined the effects of accommodation on the refractivity of the cornea have had varying results. While Cheng et al 7 detected corneal flattening after instilling 0.04% tropicamide, Yasuda et al 15 reported an increase in corneal power after inducing ciliary muscle contraction with 4% pilocarpine. It is believed that ciliary muscle contraction causes corneal steepening by acting on the peripheral cornea via the scleral spur, whereas after cycloplegia this effect is eliminated and the cornea flattens.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to refractive changes, preventing accommodation also leads to changes in anterior segment structures. 6,7,8,9,10 Keratoconus typically begins in childhood, progresses into the 40s, and then halts progression. 1 Accommodation is also at full capacity in this age group, and the effect of accommodation should not be overlooked when evaluating visual complaints.…”

Section: The Effect Of Topical Cyclopentolate On Anterior Segment Parmentioning

confidence: 99%

“…The effects of cycloplegia on refractive defects and corneal and anterior segment structures are known. 6,7,8,9,10 However, the effect of cycloplegia on biomechanically weak corneas, as in keratoconus patients, may differ from that seen in normal eyes. The effect of cycloplegia on keratometric values in eyes with keratoconus has only been investigated using an optical biometry device.…”

Section: The Effect Of Topical Cyclopentolate On Anterior Segment Parmentioning

confidence: 99%

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The Effect of Topical Cyclopentolate on Anterior Segment Parameters in Patients with Keratoconus

Kirgiz

Erdur

Çakmak

et al. 2020

tjo

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Keratoconus is characterized by progressive thinning of the cornea, corneal steepening, and irregular astigmatism. 1 The mechanical and structural changes that take place in the corneas of patients with keratoconus lead to biomechanical weakening of the cornea. The factors that cause this include changes in collagen and extracellular matrix structure and keratocyte apoptosis. 2,3 Although patients with manifest keratoconus can be diagnosed based on slit-lamp findings such as corneal steepening, Vogt lines, Fleischer ring due to iron deposition, and fractures in Bowman's membrane that appear in advanced disease, corneal topography is currently the gold standard diagnostic method. 4 Fellow eyes of patients with manifest keratoconus that do not display the typical findings of the disease and corneas that

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Section: Discussionmentioning

confidence: 99%

Section: The Effect Of Topical Cyclopentolate On Anterior Segment Parmentioning

confidence: 99%

Section: The Effect Of Topical Cyclopentolate On Anterior Segment Parmentioning

confidence: 99%

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The Effect of Topical Cyclopentolate on Anterior Segment Parameters in Patients with Keratoconus

Kirgiz

Erdur

Çakmak

et al. 2020

tjo

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“…Some studies have found corneal steepening with ciliary contraction and corneal flattening with cycloplegia [11, 12] while others have not found such an effect [13, 14]. Studies on myopic eyes have revealed corneal flattening with cycloplegia [12, 15, 16].…”

Section: Discussionmentioning

confidence: 99%

“…A blocked accommodation and the resultant decrease in lens power have historically been thought to be the reason for the postcycloplegia refractive changes. However, it is possible that the corneal power, ACD, and AL changes that are also present in this state influence the refractive state following cycloplegia [12]. This can be explained as the ACD changes are likely due to lens changes and the changes in corneal power can be calculated from the changes in K readings before and after cycloplegia.…”

Section: Discussionmentioning

confidence: 99%

Effect of Cycloplegia on Keratometric and Biometric Parameters in Keratoconus

Polat

Gündüz

2016

Journal of Ophthalmology

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Purpose. To obtain information about effect of cycloplegia on keratometry and biometry in keratoconus. Methods. 48 keratoconus (Group 1) and 52 healthy subjects (Group 2) were included in the study. We measured the flat meridian of the anterior corneal surface (K1), steep meridian of the anterior corneal surface (K2), lens thickness (LT), anterior chamber depth (ACD), and axial length (AL) using the Lenstar LS 900 before and after cycloplegia. Results. The median K1 in Group 1 was 45.64 D before and 45.42 D after cycloplegia, and the difference was statistically significant (P < 0.05). The median K2 in Group 1 was 50.96 D before and 50.17 D after cycloplegia, and the difference was significant (P < 0.05). The median K1 and K2 in Group 2 were 42.84 and 44.49 D, respectively, before cycloplegia, and 42.84 and 44.56 D after cycloplegia, and the differences were not statistically significant (all P > 0.05). There were significant differences in SE, LT, ACD, and RLP between before and after cycloplegia in either Group 1 (all P < 0.05) or Group 2 (all P < 0.05). There were not statistically significant differences in AL between before cycloplegia and after cycloplegia in either Group 1 (P = 0.533) or group 2 (P = 0.529). Conclusions. Flattened corneal curvature and increase in ACD following cycloplegia in keratoconus patients were detected.

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A comparison of cycloplegic effect of cyclopentolate 0.5% versus 1.0% eye drops with five different refraction measurement modalities in young adults

Kaiser,

Lwowski,

Nazir

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Purpose To compare the refraction before and after cycloplegia with 0.5% and 1.0% cyclopentolate eye drops using five different measurement modalities. Methods This prospective, clinical comparative study enrolled 96 eyes of 48 healthy patients with a mean age of 26.6 ± 4.21 years (range: 19–34). Subjective refraction, retinoscopy, and objective refraction were measured using three autorefractometers: Topcon KR-800 (TC), Retinomax K-plus 3 (RM + 3), and Retinomax K-plus Screeen (RM + S) under noncycloplegic and cycloplegic conditions. Cycloplegia was performed in the right eye using 0.5% and in the left eye with 1.0% cyclopentolate eye drops. Differences in refraction in noncycloplegia and cycloplegia, between cycloplegia with 0.5% and 1.0% cyclopentolate, and between the devices were investigated. Results Cycloplegic mean spherical equivalent was -1.77 ± 2.34 diopters (D) (-9.75 to + 1.625). All approaches showed a statistically significant hyperopic shift (p < 0.001, each) after induction of cycloplegia using both regimes. Lowest median (interquartile range) hyperopic shift was shown by TC (0.25 D (0.38)) and retinoscopy (0.25D (0.75)), and the highest by RM + 3 (0.75 (1.31)). No statistically significant differences between cycloplegia using 0.5% and 1.0% regimens were shown in all modalities (p > 0.05, each). In noncycloplegia, there were greater differences compared to cycloplegia. No influence of iris color on the refraction was found. Conclusion After induction of cycloplegia all devices showed a hyperopic shift and good comparability to retinoscopy. In all measurement modalities, no significant refraction differences between 0.5% and 1.0% cyclopentolate eye drops were seen. Therefore, 0.5% cyclopentolate was proven to have a sufficient effect with presumably better tolerability. Key messages What is known Cycloplegic refraction is a key test in the evaluation of any patient with active accommodation. The most frequently used clinical tests to determine the exact refraction are retinoscopy, subjective refraction, and objective refraction using autorefractometry. What is new No significant differences in the refraction between cycloplegia using 0.5% and 1.0% cyclopentolate eye drops were found. In noncycloplegia, hand-held autorefractometers tend to measure higher myopia. The evaluation of cycloplegic refraction showed good comparability between retinoscopy and subjective refraction as well as three different autorefractometers.

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Short-Term Refractive Change and Ocular Parameter Changes after Cycloplegia

Cited by 33 publications

References 28 publications

The Effect of Topical Cyclopentolate on Anterior Segment Parameters in Patients with Keratoconus

The Effect of Topical Cyclopentolate on Anterior Segment Parameters in Patients with Keratoconus

Effect of Cycloplegia on Keratometric and Biometric Parameters in Keratoconus

A comparison of cycloplegic effect of cyclopentolate 0.5% versus 1.0% eye drops with five different refraction measurement modalities in young adults

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