Effects of pharmacological mydriasis in anterior chamber depth measurements with IOL Master and Sirius

Efectos de la midriasis farmacológica en la medida de la profundidad de la cámara anterior con IOL Master y Sirius

By: A. Tobío, A. Gargallo, J. Arines, F. González

Main Information

Volume:
Vol.48-N1 / 2015 - Ordinario
Section:
Vision Sciences
Pages:
9-18
DOI:
http://dx.doi.org/10.7149/OPA.48.1.9
Type:
Introduction to Research/Introducción a la Investigación
Language:
Spanish / Español
Attachments:
Keywords:
Anterior chamber depth, anterior chamber angle, pupil dilation, IOL Master, Scheimpflug images, Sirius.

Aberraciones, cirugía de la catarata, 1 incisión, Incisiones pareadas, Sirius, topografía corneal
PDF file download

Abstract

This study aims to analyze the influence of pharmacological pupillary dilation in the anterior chamber depth (ACD) and anterior chamber angle (ACA) measured with IOL Master and Sirius. A total of 99 eyes of 50 patients were included in the sample with an age range of 15-78. 24 of them were induced with cyclopentolate 1% and 75 with tropicamide 1% and phenylephrine 10%. ACD was measured with IOL Master and ACD, ACA and pachymetry with Sirius. All the analyzed variables were statistically significant (P<0.05) except pachymetry. IOL Master measurements of ACD increased 0.068 ± 0.007 mm on average after pupillary dilatation. However, a narrowing of the anterior chamber (AC) of 0.078 ± 0.031 mm on average was found. A good correlation between Sirius and IOL Master pre dilation measures was found. The AC increased 10.92 ± 0.87 degrees on average after dilation of the pupil. There are significant differences in the ACD measured with IOL Master and Sirius before and after topical application of mydriatics and cycloplegics drugs in the eye, those differences are statistically but not clinically significant. The ACA also varied significantly. More studies are necessary in order to check the repeatability and reliability of Scheimpflug technology devices on dilated eyes.


Este estudio pretende analizar la influencia de la dilatación pupilar farmacológica en las medidas de la profundidad de la cámara anterior (PCA) y el ángulo camerular (AC) con IOL Master y Sirius. Un total de 99 ojos de 50 pacientes fueron incluidos en la muestra con un rango de edad de 15-78. 24 fueron instilados con ciclopentolato 1% y 75 con tropicamida 1% y fenilefrina 10%. Se midió la PCA con IOL Master y la PCA, el AC y la paquimetría con Sirius. Todas las variables analizadas resultaron estadísticamente significativas (P<0,05) salvo la paquimetría. La PCA medida con IOL Master aumentó de media 0,068 ± 0,007 mm tras la dilatación pupilar. Sin embargo, con Sirius la cámara anterior (CA) se estrechó 0,078 ± 0,031 mm de media. Se encontró una buena correlación entre las medidas pre dilatación con Sirius e IOL Master. El AC aumentó 10,92 ± 0,87 grados de media tras la dilatación de la pupila. La aplicación tópica de midriáticos y ciclopléjicos hace variar de manera estadísticamente aunque no clínicamente significativa la PCA usando IOL Master y Sirius. El AC también varió de manera significativa aunque harían falta más estudios con aparatos con tecnología Scheimpflug para comprobar su repetibilidad y fiabilidad a la hora de tomar medidas en ojos dilatados.

References

[1] P. L. Kaufman, A. Alm, Adlerfisiología del ojo: aplicación clínica (Ed. Elsevier, 2004).

[2] M. H. Ross, L. J. Romrell, G. I. Kaye, Histología, texto y atlas color (Ed. Panamericana, 1997).

[3] J. Pinós, A. Sabater, G. Navarro, J. Montero, L. Amselem, P. Carbonell, A. Gonzalvo, "Glaucoma pigmentario e iridotomía láser. Criterios e indicaciones actuales," Studium, 17(2) (2009).

[4] A. Domínguez, D. Monsálvez, C. Albarrán, V. Sanchís, R. Montes Micó, "Changes in anterior chamber eye during accommodation as assessed using a Dual Scheimpflug system," Arq Bras Oftalmol 77(4), 243-9 (2014).

[5] P. Arriola-Villalobos, D. Díaz-Valle, N. Garzón, J. Ruíz-Medrano, C. Fernández, A. Alejandre, J. García- Feijoó, "Effect of pharmacologic pupil dilation on OLCR optical biometry measurements for IOL predictions," Eur J Ophtalmol 24(1), 53-57 (2014). DOI

[6] R. Y. Huang, A. K. Lam, "The effect of mydriasis from phenylefrine on corneal shape," Clin Exp Optom 90(1), 44-8 (2007). DOI

[7] F. Aptel, C. Chiquet, S. Beccat, P. Denis, "Biometric evaluation of anterior chamber changes after physiologic pupil dilation using Pentacam and anterior segment optical coherence tomography," Invest Ophtalmol Vis Sci 53(7), 40005-10 (2012). DOI

[8] F. Aptel, P. Denis, "Optical coherence tomography quantitative analysis of iris volume changes after pharmacologic mydriasis. Ophthalmology 117, 3-10 (2010). DOI

[9] J García, J; Cuiña, R. Bases físicas de la biomicroscopía ultrasónica. En: Sánchez Salorio M, García-Feijóo J, Pazos González B. Biomicroscopía ultrasónica en oftalmologíva. 1a Edición. Tecnimedia editorial; (1998).

[10] G. Villanueva, L. Perdiz, P. Juárez, F. Castañeda, "Anterior chamber depth measurement using Ultrasound A, Orbscan II, OCT Visante and UBM. A comparative study," Rev Mex Oftalmol 83(4), 221-225 (2009).

[11] R. J. Smith, "A new method of estimating de depth of anterior chamber," Br J Ophtalmol 63, 215-220 (1979). DOI

[12] W. A. Douthwaite, D. Spence, "Slit-lamp measurement of the anterior chamber depth," Br J Ophtalmol 70, 205-208 (1978). DOI

[13] M. Bjelos Roncevic, M. Busic, I. Cima, B. Kuzmanovic Elabjer, D. Bosnar, D. Miletic, "Intraobserver and interobserver repeatability of ocular components measurement in cataract eyes using a new optical low coherence reflectometer Graefes," Arch Clin Exp Ophthalmol 249(1), 83-7 (2011) DOI

[14] S. Salim, "The Role of Anterior Segment Optical Coherence Tomography in Glaucoma," J Ophthalmol 2012, (2012).

[15] R. Jain, "Pentacam: principle and clinical applications. Journal of Current Glaucoma Pratice," 3(2), 20-32 (2009). DOI

[16] A. Orts, Fundamentos de farmacología ocular (AEOA, 1994).

[17] Manual de funcionamiento Sirius 2.5. Oftaltech. H. Eleftheriadis, "IOLMaster biometry: refractive results of 100 consecutive cases," Br J Ophthalmol 87, 960-963 (2003). DOI

[18] J. Zhao, Z. Chen, Z. Zhou, L. Ding, X. Zhou, "Evaluation of the repeatability of the Lenstar and comparison with two other non-contact biometric devices in myopes," Clin Exp Optom 96(1), 92-9 (2013). DOI

[19] M. C. Mocan, S. Ustunel, O. Dikmetas, B. Bozkurt, M. Irkec, "The effect of pharmacologic pupillary dilatation on anterior segments parameters in patients with exfoliation syndrome," J Optom 7(1), 51-6 (2014). DOI

[20] S. Sarkar, A. M. Hasnat, S. R. Bharadwaj, "Revisiting the impact of phenylephrine hydrochloride on static and dynamic accommodation," Indian J Ophthalmol 60(6), 503-9 (2012). DOI

[21] I. L. Tsai, C. Y. Tsai, L. L. Kuo, S. W. Liou, S. Lin, I. J. Wamg, "Transient changes of intraocular pressure and anterior segment configuration after diagnostic midriasis with 1% tropicamide in children," Clin Exp Optom 95(2), 166-72 (2012). DOI

[22] A. Bedei, I. Appolloni, A. Madesani, A. Pietrelli, S. Franceschi, L. Barabesi, "Repeatability and agreement of 2 Scheimpflug analyzers in measuring the central corneal thickness and anterior chamber angle, volumen, and depth," Eur J Ophthalmol 22, 29-32 (2012) DOI

[23] G. Savini, M. Carbonelli, A. Sbreglia, P. Barboni, G. Deluigi, J. K. Hoffer, "Comparison of anterior segment measurements by 3 Scheimpflug tomographers and 1 Placido corneal topographer," J Cataract Refract Surg 37, 1679-1685 (2011). DOI

[24] C. López de la Fuente, A. Sánchez-Cano, F. Segura, I. Pinilla, "Comparison of Anterior Segment Measurements Obtained by Three Different Devices in Healthy Eyes," Biomed Res Int 2014 (2014) Article ID 498080.

[25] M. A. Anayol, E. Güler, R. Yagci, M. A. Sekeroglu, M. Ytlmazoglu, H. Tirhis, A. E. Kulak, P. Yilmazbas, "Comparison of Central Corneal Thickness, Thinnest Corneal Thickness, Anterior Chamber Depth, and Simulated Keratometry Using Galilei, Pentacam, and Sirius Devices," Cornea 33, 582-586 (2014). DOI

[26] A. Narayanaswamy, C. Zheng, S. A. Perera, H. M. Htoon, D. S. Friedman, T. A. Tun, M. He, M. Baskaran, T. Aung, "Variations in iris volume with physiologic mydriasis in subtypes of primary angle closure glaucoma," Invest Ophtalmol Vis Sci 54(1), 708-13 (2013). DOI

[27] C. Y. Cheung, S. Liu, R. N. Weinreb, J. Liu, H. Li, D. Y. Leung, S. Dorairaj, J. Liebmann, R. Ritch, D. S. Lam, C. K. Leung, "Dynamic analysis of iris configuration with anterior segment optical coherence tomography," Invest Ophthalmol Vis Sci 51(8), 4040-6(2010). DOI