Tan Si-Yi, Liu Dian-Feng, Wang Wei-Qi, Wang Bing-Song
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Int J Ophthalmol. 2025 Mar 18;18(3):518-525. doi: 10.18240/ijo.2025.03.20. eCollection 2025.
To investigate the effect of pharmacological pupil alterations on intraocular lens (IOL) power calculations.
A systematic review and Meta-analysis of studies published before December 2023 in the PubMed, Embase, and Cochrane library databases on the accuracy of pharmacological pupil changes on IOL power calculation was performed. The primary outcome was the results of IOL power calculations before and after the use of medications. Subgroup analyses were performed based on participants' basic characteristics, such as age, axial length (AL), and whether miosis or mydriasis were used as classification criteria for further analyses. Each eligible study was evaluated for potential risk of bias by the AHRQ assessment scale. The study was registered on PROSPERO (CRD 42024497535).
A total of 3062 eyes from 21 studies were eligible. There was no significant difference in the IOL power calculation before and after pharmacological pupil changes using any of the Hoffer Q (WMD=0.055, 95%CI=-0.046-0.156; =0.29), SRK/T (WMD=0.003, 95%CI=-0.073-0.080; =0.93), Haigis (WMD=-0.030, 95%CI=-0.176-0.116; =0.69), Holladay 2 (WMD=-0.042, 95%CI=-0.366-0.282; =0.80), and Barrett Universal II (WMD=0.033, 95%CI=-0.061-0.127; =0.49) formulas. On the measurement of parameters related to IOL power calculation, for either miosis or mydriasis AL (=0.98 and 0.29, respectively), lens thickness (=0.96 and 0.13, respectively), and mean keratometry (=0.90 and 0.86, respectively) did not present significant differences, while anterior chamber depth (=0.07 and <0.01, respectively) and white-to-white distance (=0.01 and 0.04, respectively) changed significantly between the two measurements prior and posterior. At the same time, despite there being some participants with the difference between the before and after calculations greater than 0.5 diopter, there was no significant difference in the incidence rate between these formulas.
There is no significant effect of pharmacological pupil changes on the IOL power calculation. It will considerably reduce the visit time burden for patients who require cataract surgery.
探讨药物性瞳孔改变对人工晶状体（IOL）屈光力计算的影响。
对2023年12月前发表在PubMed、Embase和Cochrane图书馆数据库中关于药物性瞳孔变化对IOL屈光力计算准确性的研究进行系统综述和Meta分析。主要结局是使用药物前后IOL屈光力计算的结果。根据参与者的基本特征进行亚组分析，如年龄、眼轴长度（AL），以及是否以瞳孔缩小或散大作为分类标准进行进一步分析。采用AHRQ评估量表对每项符合条件的研究进行潜在偏倚风险评估。该研究已在PROSPERO（CRD 42024497535）注册。
共有来自21项研究的3062只眼符合条件。使用任何一种Hoffer Q公式（加权均数差[WMD]=0.055，95%置信区间[CI]=-0.046-0.156；P=0.29）、SRK/T公式（WMD=0.003，95%CI=-0.073-0.080；P=0.93）、Haigis公式（WMD=-0.030，95%CI=-0.176-0.116；P=0.69）、Holladay 2公式（WMD=-0.042，95%CI=-0.366-0.282；P=0.80）和Barrett Universal II公式（WMD=0.033，95%CI=-0.061-0.127；P=0.49）时，药物性瞳孔改变前后IOL屈光力计算均无显著差异。在测量与IOL屈光力计算相关的参数时，无论是瞳孔缩小还是散大，眼轴长度（P分别为0.98和0.29）、晶状体厚度（P分别为0.96和0.13）以及平均角膜曲率（P分别为0.90和0.86）均无显著差异，而前房深度（P分别为0.07和<0.01）和白对白距离（P分别为0.01和0.04）在用药前后两次测量之间有显著变化。同时，尽管有一些参与者计算前后的差异大于0.5屈光度，但这些公式之间的发生率无显著差异。
药物性瞳孔改变对IOL屈光力计算无显著影响。这将大大减轻需要白内障手术患者的就诊时间负担。
