Kaiser Klemens Paul, Lwowski Christoph, Nazir Faisal, Kohnen Thomas, Wenner Yaroslava
Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Graefes Arch Clin Exp Ophthalmol. 2025 Apr;263(4):1135-1146. doi: 10.1007/s00417-024-06658-9. Epub 2024 Nov 23.
To compare the refraction before and after cycloplegia with 0.5% and 1.0% cyclopentolate eye drops using five different measurement modalities.
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.
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.
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.
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.
使用五种不同测量方式比较使用0.5%和1.0%环喷托酯滴眼液散瞳前后的屈光情况。
这项前瞻性临床对照研究纳入了48例健康患者的96只眼，平均年龄为26.6±4.21岁（范围：19 - 34岁）。在未散瞳和散瞳状态下，使用三种自动验光仪：拓普康KR - 800（TC）、视网膜视力计K - plus 3（RM + 3）和视网膜视力计K - plus屏幕型（RM + S）测量主观验光、检影验光和客观验光。右眼使用0.5%环喷托酯滴眼液，左眼使用1.0%环喷托酯滴眼液进行散瞳。研究了未散瞳和散瞳状态下的屈光差异、0.5%和1.0%环喷托酯散瞳之间的差异以及不同仪器之间的差异。
散瞳后的平均球镜等效度为-1.77±2.34屈光度（D）（-9.75至+1.625）。两种散瞳方案散瞳后，所有测量方法均显示出具有统计学意义的远视偏移（各p < 0.001）。TC（0.25 D（0.38））和检影验光（0.25D（0.75））显示的最低中位数（四分位间距）远视偏移，RM + 3显示的最高（0.75（1.31））。所有测量方式中，使用0.5%和1.0%散瞳方案之间均未显示出统计学显著差异（各p > 0.05）。在未散瞳状态下，与散瞳状态相比差异更大。未发现虹膜颜色对屈光有影响。
散瞳后所有仪器均显示出远视偏移，且与检影验光具有良好的可比性。在所有测量方式中，0.5%和1.0%环喷托酯滴眼液之间未观察到显著的屈光差异。因此，已证明0.5%环喷托酯具有足够的效果，且耐受性可能更好。
已知信息 散瞳验光在评估任何有活跃调节的患者中是一项关键检查。确定准确屈光的最常用临床检查是检影验光、主观验光和使用自动验光仪的客观验光。新发现 使用0.5%和1.0%环喷托酯滴眼液散瞳后的屈光无显著差异。在未散瞳状态下，手持式自动验光仪往往测量出更高的近视度数。散瞳验光评估显示检影验光与主观验光以及三种不同自动验光仪之间具有良好的可比性。
