The effect of pupillary dilatation on IOL power measurement by using the IOLMaster

Khambhiphant, Bharkbhum; Chatbunchachai, Nattida; Pongpirul, Krit

doi:10.1007/s10792-015-0063-9

Cited by 19 publications

(23 citation statements)

References 22 publications

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“…Our previous study showed that pupil dilation does not have an effect on the IOL power measurement using the IOLMaster ® (Carl Zeiss Meditec AG, Jena, Germany). 6 However, the study was conducted based on the SRK-T formula and the anterior chamber depth (ACD) was significantly increased postdilation, which was comparable to other reports. 6 – 10 …”

Section: Introductionsupporting

confidence: 76%

Effect of pupillary dilation on Haigis formula-calculated intraocular lens power measurement by using optical biometry

Khambhiphant

Sasiwilasagorn

Chatbunchachai

et al. 2016

OPTH

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PurposeThe 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®.MethodsA 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.ResultsThe 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.ConclusionBiometry measurements in the cycloplegic stage should be considered in the IOL formulas that use parameters other than AL and K.

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Section: Introductionsupporting

confidence: 76%

Effect of pupillary dilation on Haigis formula-calculated intraocular lens power measurement by using optical biometry

Khambhiphant

Sasiwilasagorn

Chatbunchachai

et al. 2016

OPTH

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“…This is simply due to the pharmaceutical effects on the pupil-dilatator muscle and ciliary smooth muscle. In the present study, the magnitude of LT thinning was smaller than that of ACD deepening, indicating that the crystal lens and iris plane might move backward due to the pull force of the relaxed ciliary muscle [ 24 , 34 – 37 ]. Meanwhile, AL was found to significantly shorten after the administration of the adrenergic and anticholinergic agents used in the study.…”

Section: Discussionmentioning

confidence: 85%

Time-Course of Changes in Choroidal Thickness after Complete Mydriasis Induced by Compound Tropicamide in Children

Zeng

Jin

et al. 2016

PLoS ONE

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PurposeThe aim of this study was to investigate the time-course of changes in choroidal thickness (ChT) following complete mydriasis induced by compound tropicamide.MethodsChT was measured by OCT with the enhanced-depth imaging technique (Spectralis HRA+OCT, Heidelberg Engineering, Germany) at nine locations of the fundus: subfoveal ChT (SFChT) and ChT at 1 mm and 3 mm from the fovea in four quadrants. Mydriasis was induced with compound tropicamide (0.5% tropicamide plus 0.5% phenylephrine hydrochloride, three doses at 5-minute intervals). Measurements were conducted prior to the instillation and at 0, 30, and 60 min following complete mydriasis. Results at different time-points were compared using repeated-measures ANOVA to investigate the time-course of the changes.ResultsThirty-nine subjects (mean age 11.9±2 years; 16 males and 23 females) were enrolled in the study. Compound tropicamide resulted in a statistically significant decrease in SFChT at 0, 30, and 60 min after complete mydriasis, as compared to baseline (−5±4 μm, −12±4 μm, and −13±4 μm, respectively; all P<0.0001). No significant changes were detected in the parafoveal choroid except at 1 mm temporal (T1mm) and nasal (N1mm) to the fovea at 30 and 60 min (T1mm: −6±4 μm and −7±5 μm at 30 and 60 min; N1mm: −6±4 μm and −7±5 μm at 30 and 60 min, respectively; all P<0.0001). Repeated-measures ANOVA showed a significant interaction between the time after complete mydriasis and the effect of the mydriasis agent.ConclusionsComplete mydriasis induced by compound tropicamide led to choroidal thinning, and the magnitude varied over time.

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“…3) Many studies have investigated the influence of pupil dilation on these biometric measurements. 8,[10][11][12][13][14][15][16] In a clinical setting, pupil dilation is a vital process of preoperative examination. Therefore, it is important to analyze its possible influence on PPR and recommended IOL power in third, fourth, and new generation IOL power calculation formulas, and to investigate the correlation between variables.…”

Section: Resultsmentioning

confidence: 99%

“…[10][11][12] However, ACD has been reported to be influenced by pupil dilation. [10][11][12][13][14] Compared to ACD, few studies have dealt with the influence of pupil dilation on LT and WTW. Wang X et al 8) demonstrated that LT was significantly affected by pupil dilation.…”

Section: Resultsmentioning

confidence: 99%

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

Teshigawara

Meguro

Mizuki

2020

Preprint

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Background: We investigated the effect of pupil dilation on predicted postoperative refraction (PPR) and recommended intraocular lens (IOL) power calculated using three different generations of IOL power calculation formulas: Barrett Universal II (Barrett) (new generation), Haigis (4th generation), and SRK/T (3rd generation). 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 correlations between all changes were analyzed using the Wilcoxon signed-rank test and the Spearman’s rank-order correlation test, respectively. The influence of pupil dilation on recommended IOL power calculated by each formula was also analyzed. Results: The mean absolute change (MAC) in PPR before and after dilation was highest in Barrett, followed by Haigis and SRK/T. Significant differences were found among each MACs (P < 0.0001). Significant changes were observed before and after dilation in ACD and LT (P < 0.0001) but not in WTW. In Barrett and Haigis, there was a significant positive correlation between 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). Correlations were strongest in Barret followed by Haigis, especially in LT. Change in PPR in Barrett also demonstrated a significant positive correlation with change in WTW (P = 0.022). The recommended IOL power using Barrett and Haigis changed before and after dilation in 23.3% and 19.3% cases; SRK/T showed no change. Conclusions: In PPR and recommended IOL power, pupil dilation influenced Barrett most strongly, followed by Haigis and SRK/T. Given the stronger correlation between the change in PPR in Barrett and the change in ACD, LT, and WTW, the change of ACD, LT, and WTW is more important to the influence of dilation on Barrett. The influence of dilation on each formula and variable, including ACD, LT, and WTW, is key to improving IOL calculation.

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The effect of pupillary dilatation on IOL power measurement by using the IOLMaster

Cited by 19 publications

References 22 publications

Effect of pupillary dilation on Haigis formula-calculated intraocular lens power measurement by using optical biometry

Effect of pupillary dilation on Haigis formula-calculated intraocular lens power measurement by using optical biometry

Time-Course of Changes in Choroidal Thickness after Complete Mydriasis Induced by Compound Tropicamide in Children

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

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