Taneri S, Stottmeister S, Krause K
Zentrum für Refraktive Chirurgie, Augenklinik am St. Franziskus Hospital, Münster.
Klin Monbl Augenheilkd. 2010 Jan;227(1):56-60. doi: 10.1055/s-0028-1109652. Epub 2010 Jan 20.
Wavefront-guided ablations are based on wavefront sensing in a pupil dilated under mesopic conditions, or in patients with insufficient natural pupil dilation, after the application of mydriatic eye drops. The aim of this study was to investigate a potential influence of mydriatic eye drops on wavefront-sensing in terms of the predicted phoropter refraction (PPR).
In this prospective study 70 myopic eyes were measured in miosis and pharmacologically induced mydriasis with the Zywave aberrometer and automated refraction (Canon R-F10). 52 eyes were dilated with eye drops containing tropicamide 0.5 % and phenylephrine 2.5 %, in the remaining 18 eyes tropicamide 0.5 % was used. The PPR for a pupil diameter of 3.5 mm in miosis and in mydriasis, respectively, were compared and correlated to the corresponding values of the automated refraction.
PPR values obtained in mydriasis were less myopic than in miosis. The sphere of PPR differed by an average of + 0.19 +/- 0.3 diopters (range: -1.07 to + 0.37 diopters) when using tropicamide 0.5 % and phenylephrine 2.5 %. With tropicamide 0.5 % eye drops the difference was + 0.25 +/- 0.4 diopters (range: -1.12 diopters to + 0.27 diopters). Cylinder values were not affected. Automated refraction yielded a smaller difference of + 0.16 +/- 0.33 diopters (tropicamide 0.5 % and phenylephrine 2.5 %) and + 0.1 +/- 0.19 diopters (tropicamide 0.5 %). Cylinder values changed significantly.
The cycloplegic effect of mydriatic eye drops should be taken into account when interpreting aberration measurements and planning a wavefront-guided laser ablation.
波前引导消融术基于在中暗视觉条件下瞳孔散大时或在使用散瞳眼药水后自然瞳孔散大不足的患者中进行的波前传感。本研究的目的是根据预测的综合验光仪验光结果(PPR),研究散瞳眼药水对波前传感的潜在影响。
在这项前瞻性研究中,使用ZyWave像差仪和自动验光仪(佳能R-F10)对70只近视眼在瞳孔缩小和药物诱导散瞳状态下进行测量。52只眼睛用含有0.5%托吡卡胺和2.5%去氧肾上腺素的眼药水散瞳,其余18只眼睛使用0.5%托吡卡胺。分别比较了瞳孔缩小和散瞳状态下瞳孔直径为3.5mm时的PPR,并将其与自动验光的相应值进行关联。
散瞳时获得的PPR值比瞳孔缩小时的近视程度轻。使用0.5%托吡卡胺和2.5%去氧肾上腺素时,PPR的球镜度数平均相差+0.19±0.3屈光度(范围:-1.07至+0.37屈光度)。使用0.5%托吡卡胺眼药水时,差异为+0.25±0.4屈光度(范围:-1.12屈光度至+0.27屈光度)。柱镜度数不受影响。自动验光的差异较小,分别为+0.16±0.33屈光度(0.5%托吡卡胺和2.5%去氧肾上腺素)和+0.1±0.19屈光度(0.5%托吡卡胺)。柱镜度数有显著变化。
在解释像差测量结果和规划波前引导激光消融时,应考虑散瞳眼药水的睫状肌麻痹作用。