Miyop hastalarda sikloplejinin korneal keratometrik ölçümlere etkisi

Yıl 2024, Cilt: 29 Sayı: 3, 297 - 303, 23.09.2024

Konuralp Yakar

https://doi.org/10.21673/anadoluklin.1407238

Öz

Amaç: Bu çalışmanın amacı oftalmolojik muayenede sikloplejik-midriyatik olarak kullanılan %1 siklopentolat hidroklorür damlanın korneal keratometrik değerlere etkisini araştırmak, siklopleji-midriazis sonrası ölçülen keratometrik değerlerin refraktif cerrahi ve biyometrik hesaplamalarda kullanılıp kullanılamayacağını ortaya koymaktır.

Yöntemler: Kesitsel prospektif planlanan çalışmaya, Ocak 2022-Nisan 2023 tarihleri arasında rutin göz muayenesi için polikliniğe başvuran sağlıklı erişkin 110 hastanın sağ gözü dâhil edildi. Standart otorefraktokeratometreyle (Topcon KR 8100) ölçülen korneal keratometrik veriler (K1, K1mm, K1 aks, K2, K2mm, K2 aks, K ortalama, korneal astigmatik değer) %1 siklopentolat hidroklorür 3 defa damlatıldıktan 45 dakika sonra elde edilen siklopleji sonrasındaki keratometrik ölçümlerle karşılaştırıldı.

Bulgular: Olguların medyan yaşı 25 (minimum 18-maksimum 40 yıl) idi. Cinsiyet dağılımı eşitti. Olguların siklopleji öncesi ölçülen K1, K1mm, K1 aks, K2, K2mm, K2 aks, K ortalama, korneal astigmatik değerlerinde siklopleji-midriyazis sonrasında istatiksel olarak anlamlı fark saptanmadı (p>0,05).

Sonuç: Sağlıklı erişkin bireylerde korneal keratometrik değerler %1 siklopentolat ile oluşturulan siklopleji-midriyazisten etkilenmemektedir.

Anahtar Kelimeler

Astigmatizm, kornea, midriyaz, siklopentolat, siklopleji

Effect of cycloplegia on corneal keratometric measurements in myopic patients

Öz

Aim: The purpose of this study was to investigate the effect of 1% cyclopentolate hydrochloride drops used as cycloplegic-mydriatic in ophthalmologic examination on corneal keratometric values and to determine whether keratometric values measured after cycloplegia-mydriasis can be used in refractive surgery and biometric calculations.

Methods: The cross-sectional prospective study included the right eye of 110 healthy adult patients who presented to the outpatient clinic for routine ophthalmologic examination between January 2022 and April 2023. Corneal keratometric data (K1, K1mm, K1 axis, K2, K2mm, K2 axis, K mean, corneal astigmatic value) measured with a standard autorefractokeratometer (Topcon KR 8100) were compared with keratometric measurements after cycloplegia obtained 45 minutes after 3 instillations of 1% cyclopentolate hydrochloride.

Results: The median age of the patients was 25 years (minimum 18-maximum 40 years). Gender distribution was equal. There were no statistically significant differences in corneal keratometric values (K1, K1mm, K1 axis, K2, K2mm, K2 axis, K mean, corneal astigmatic value) before and after induction of cycloplegia (p>0.05).

Conclusion: Corneal keratometric values are not affected by cycloplegia-mydriasis induced by 1% cyclopentolate in healthy adult subjects.

Anahtar Kelimeler

Astigmatism, cyclopentolate, cycloplegia, cornea, mydriasis

Kaynakça

• Fotedar R, Rochtchina E, Morgan I, Wang JJ, Mitchell P, Rose KA. Necessity of cycloplegia for assessing refractive error in 12-year-old children: a population-based study. Am J Ophthalmol. 2007;144(2):307-9.
• Hopkins S, Sampson GP, Hendicott P, Lacherez P, Wood JM. Refraction in children: a comparison of two methods of accommodation control. Optom Vis Sci. 2012;89(12):1734-9.
• Zhao J, Mao J, Luo R, Li F, Pokharel GP, Ellwein LB. Accuracy of noncycloplegic autorefraction in school-age children in China. Optom Vis Sci. 2004;81(1):49-55.
• Yolton DP, Kandel JS, Yolton RL. Diagnostic pharmaceutical agents: side effects encountered in a study of 15,000 applications. J Am Optom Assoc. 1980;51(2):113-8
• Yazdani N, Sadeghi R, Momeni-Moghaddam H, Zarifmahmoudi L, Ehsaei A. Comparison of cyclopentolate versus tropicamide cycloplegia: A systematic review and meta-analysis. J Optom. 2018;11(3):135-43.
• Kiess RD, Fralick FB. A preliminary report on a new cycloplegic and mydriatic drug. Am J Ophthalmol. 1951;34(11):1593-5.
• Gordon DM, Ehrenberg MH. Cyclopentolate hydrochloride: A new mydriatic and cycloplegic agent; a pharmacologic and clinical evaluation. Am J Ophthalmol. 1954;38(6):831-8
• Milder B, Riffenburgh RS. An evaluation of cyclogyl (compound 75 GT). Am J Ophthalmol. 1953;36(12):1724-26.
• Bartlett JD. Administration of and adverse reactions to cycloplegic agents. Am J Optom Physiol Optics.1978;55(4):227-33.
• Egashira SM, Kish LL, Twelker JD, Mutti DO, Zadnik K, Adams AJ. Comparison of cyclopentolate versus tropicamide cycloplegia in children. Optom Vis Sci.1993;70(12):1019-26.
• Contreras-Salinas H, Orozco-Ceja V, Romero-López MS, Barajas-Virgen MY, Baiza-Durán LM, Rodríguez-Herrera LY. Ocular Cyclopentolate: A Mini Review Concerning Its Benefits and Risks. Clin Ophthalmol. 2022;16:3753-62.
• Imai T, Hasebe S, Furuse T, et al. Adverse reactions to 1% cyclopentolate eye drops in children: an analysis using logistic regression models. Ophthalmic Physiol Opt. 2021;41(2):424-30.
• Awan KJ. Adverse systemic reactions of topical cyclopentolate hydrochloride. Ann Ophthalmol. 1976;8(6):695-8.
• Hoshikawa R, Kamiya K, Fujimura F, Shoji N. Comparison of Conventional Keratometry and Total Keratometry in Normal Eyes. Biomed Res Int. 2020;2020:8075924.
• Liu Y, Wang Y, Wang Z, Zuo T. Effects of error in radius of curvature on the corneal power measurement before and after laser refractive surgery for myopia. Ophthalmic Physiol Opt. 2012;32(4):355-61.
• Wong HB, Machin D, Tan SB, Wong TY, Saw SM. Ocular component growth curves among Singaporean children with different refractive error status. Invest Ophthalmol Vis Sci. 2010;51(3):1341-7.
• Zeng J, Cui Y, Li J, et al. Correlation of axial length and corneal curvature with diopter in eyes of adults with anisometropia. Int J Clin Exp Med. 2015;8(8):13639-43.
• Mehravaran S, Asgari S, Bigdeli S, Shahnazi A, Hashemi H. Keratometry with five different techniques: a study of device repeatability and inter-device agreement. Int Ophthalmol. 2014;34(4):869-75.
• Saitoh K, Yoshida K, Hamatsu Y, Tazawa Y. Changes in the shape of the anterior and posterior corneal surfaces caused by mydriasis and miosis: detailed analysis. J Cataract Refract Surg. 2004;30(5):1024-30.
• Cheng HC, Hsieh YT. Short-term refractive change and ocular parameter changes after cycloplegia. Optom Vis Sci. 2014;91(9):1113-7.
• Ho MC, Hsieh YT, Shen EP, Hsu WC, Cheng HC. Short-term refractive and ocular parameter changes after topical atropine. Taiwan J Ophthalmol. 2019;10(2):111-5.
• Hashemi H, Asharlous A, Khabazkhoob M, et al. The Effect of Cyclopentolate on Ocular Biometric Components. Optom Vis Sci. 2020;97(6):440-7.
• Tasci YY, Yesilirmak N, Yuzbasioglu S, Ozdas D, Temel B. Comparison of effects of mydriatic drops (1% cyclopentolate and 0.5% tropicamide) on anterior segment parameters. Indian J Ophthalmol. 2021;69(7):1802-7.
• Bagheri A, Feizi M, Shafii A, Faramarzi A, Tavakoli M, Yazdani S. Effect of cycloplegia on corneal biometrics and refractive state. J Ophthalmic Vis Res. 2018;13(2):101-9.
• Megwas AU, Ogbuagu FU, Azuamah YC, Nwakamma GI, Nwawume IC, Ugwoke GI. Effect of cyclopentolate hydrochloride 1% on the corneal curvature of different refractive status. Int J Res Rev. 2020;7(6):471-75.