Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India.
Director of Vitreoretina Services, Amritsar Eye Hospital, Amritsar, Punjab, India.
Indian J Ophthalmol. 2023 Mar;71(3):818-823. doi: 10.4103/ijo.IJO_1175_22.
The purpose of the study is to investigate the effects of combined 0.8% tropicamide and 5% phenylephrine on the corneal parameters using Pentacam.
The study was performed on 200 eyes of 100 adult patients visiting the ophthalmology clinic for evaluation of refractive errors or cataract screening. Mydriatic drops (Tropifirin; Java, India) containing tropicamide 0.8%, phenylephrine hydrochloride 5%, and chlorbutol 0.5% (as a preservative) were instilled into the eyes of the patients three times every 10 minutes. The Pentacam was repeated after 30 minutes. The measurement data of various corneal parameters from different Pentacam displays (keratometry, pachymetry, densitometry, and Zernike analysis) was manually compiled on an Excel spreadsheet and analyzed using Statistical Package for the Social Sciences (SPSS) 20 software.
Analysis of Pentacam refractive maps revealed a statistically significant increase (P < 0.05) in the values of radius peripheral (cornea front), pupil center Pachymetry, pachymetry apex, thinnest location Pachymetry, and cornea volume. However, pupil dilation did not affect the Q-value (asphericity). Analysis of the densitometry values revealed significant increase in all zones. Aberrations maps revealed statistically significant increase in the value of spherical aberration after the induction of mydriasis, but the values of Trefoil 0º, Trefoil 30º, Koma 90º, and Koma 0º were not affected significantly. We did not observe any untoward effect of the drug, except transient blurring of vision.
The current study showed that routine mydriasis in the eye clinics leads to a significant increase in various corneal parameters including corneal pachymetry, cornea densitometry, and spherical aberration as measured by Pentacam, which can influence the decision-making in the management of various corneal diseases. The ophthalmologists should be aware of these issues and make adjustments in their surgical planning accordingly.
本研究旨在使用 Pentacam 研究 0.8%托吡卡胺和 5%苯肾上腺素联合对角膜参数的影响。
该研究纳入了 200 只眼 100 例成年患者，这些患者因屈光不正评估或白内障筛查就诊于眼科门诊。患者双眼每 10 分钟滴 3 次含 0.8%托吡卡胺、5%盐酸苯肾上腺素和 0.5%氯丁醇（作为防腐剂）的 Tropifirin（印度 Java）散瞳剂。滴药 30 分钟后重复 Pentacam 检查。手动将不同 Pentacam 显示（角膜曲率、厚度计、密度计和 Zernike 分析）的各种角膜参数的测量数据编制到 Excel 电子表格中，并使用 SPSS 20 软件进行分析。
Pentacam 屈光地图分析显示，半径周边（角膜前表面）、瞳孔中心厚度计、顶点厚度计、最薄位置厚度计和角膜体积的数值均有统计学显著增加（P<0.05）。然而，瞳孔扩张并不影响 Q 值（非球性）。密度计值分析显示所有区域均有显著增加。像差图显示散瞳后球差值有统计学显著增加，但 Trefoil 0°、Trefoil 30°、Koma 90°和 Koma 0°的值没有明显变化。除短暂视力模糊外，我们未观察到药物的任何不良反应。
本研究表明，眼科门诊常规散瞳可导致 Pentacam 测量的各种角膜参数（包括角膜厚度、角膜密度和球差）显著增加，这可能影响各种角膜疾病的管理决策。眼科医生应意识到这些问题，并相应地调整手术计划。
