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Effect of pharmacological pupil dilation on measurements and iol power calculation made using the new swept-source optical coherence tomography-based optical biometer

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https://mail.google.com/mail/u/0/dx.doi.org/10.1016/j.jfo.2016.09.003
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2016-10-25
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Elsevier
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Purpose: to determine whether pupil dilation affects biometric measurements and intraocular lens (IOL) power calculation made using the new swept-source optical coherence tomography-based optical biometer (IOLMaster 700©; Carl Zeiss Meditec, Jena, Germany). Procedures: eighty-one eyes of 81 patients evaluated for cataract surgery were prospectively examined using the IOLMaster 700© before and after pupil dilation with tropicamide 1%. The measurements made were: axial length (AL), central corneal thickness (CCT), aqueous chamber depth (ACD), lens thickness (LT), mean keratometry (MK), white-to-white distance (WTW) and pupil diameter (PD). Holladay II and SRK/T formulas were used to calculate IOL power. Agreement between measurement modes (with and without dilation) was assessed through intraclass correlation coefficients (ICC) and Bland-Altman plots. Results: mean patient age was 75.17 ± 7.54 years (range: 57–92). Of the variables determined, CCT, ACD, LT and WTW varied significantly according to pupil dilation. Excellent intraobserver correlation was observed between measurements made before and after pupil dilation. Mean IOL power calculation using the Holladay 2 and SRK/T formulas were unmodified by pupil dilation. Conclusions: the use of pupil dilation produces statistical yet not clinically significant differences in some IOLMaster 700© measurements. However, it does not affect mean IOL power calculation.
Propos Déterminer si la dilatation pupillaire modifie les mesures biométriques et le calcul de la puissance de l’implant intraoculaire obtenus avec un nouveau biomètre optique basé sur la tomographie par cohérence optique swept-source (IOLMaster 700© ; Carl Zeiss Meditec, Jena, Allemagne) Méthodes Nous avons évalué prospectivement 81 yeux de 81 patients prévus pour la chirurgie de la cataracte au moyen du biomètre IOLMaster 700©, avant et après dilatation pupillaire avec tropicamide 1 %. Les mesures réalisées ont été : longueur axiale (AL), épaisseur cornéenne centrale (CCT), profondeur de la chambre antérieure (épaisseur cornéenne exclue) (ACD), épaisseur cristallinienne (LT), kératométrie moyenne (MK), distance blanc à blanc (WTW) et diamètre pupillaire (PD). Les formules Holladay II et SRK/T ont été employées pour calculer la puissance de l’implant intraoculaire. Nous avons évalué la concordance entre les deux méthodes de mesure (sous dilatation pupillaire et sans) au moyen des coefficients de corrélation intraclasse (ICC) et des graphiques de Bland-Altman. Résultats La moyenne d’âge des patients était de 75,17 ± 7,54 ans (intervalle : 57–92). Parmi les variables mesurées, la CCT, l’ACD, la LT et la WTW montraient des variations significatives en fonction de la dilatation pupillaire. On a observé une excellente corrélation intra-observateur entre les mesures réalisées avant et après la dilatation pupillaire. Celle-ci ne modifiait pas la prédiction de la puissance moyenne de l’implant avec Holladay 2 et SKR/T. Conclusions L’emploi de tropicamide 1 % produit des différences significatives du point de vue statistique mais pas clinique sur certaines mesures réalisées avec IOLMaster 700©. Cependant, la mesure de la puissance moyenne de l’implant intraoculaire n’est pas affectée.
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Received 11 July 2016, Accepted 2 September 2016, Available online 25 October 2016
UCM subjects
Diagnóstico por imagen y medicina nuclear , Oftalmología
Unesco subjects
3204.01 Medicina Nuclear , 3201.09 Oftalmología
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https://hdl.handle.net/20.500.14352/19006
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