Meta-analysis of the effect and safety of Cyclopentolate and Atropine on ciliary muscle paralysis in myopic children / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To systematically evaluate the effect and safety of cyclopentolate and atropine on ciliary muscle paralysis before optometry in myopic children. <p>METHODS: Relevant references published before April 2020, which concerned about cyclopentolate compared with atropine for ciliary muscle palsy in children with myopia, were obtained by searching PubMed, EMBASE, Web of Science, The Cochrane Library, CNKI and WanFang Database. For the selected studies, after data extraction and methodological quality evaluation of the included study, RevMan5.3 software was used for Meta-analysis. <p>RESULTS: Nine articles were finally included, containing 588 eyes using atropine and 592 eyes using cyclopentolate. Meta-analysis results indicated: comparing of cyclopentolate and atropine for cycloplegia in children with myopia before optometry, the diopter difference between the two is <i>WMD</i>: -0.01, 95%<i>CI</i>(-0.30, 0.27), <i>P</i>=0.93; the difference in residual accommodation power between the two is <i>WMD</i>: 0.22, 95%<i>CI</i>(-0.13, 0.58), <i>P</i>=0.22. In addition, the cyclopentolate is safer and has a lower incidence of adverse reactions.<p>CONCLUSION: Compared with atropine, cyclopentolate has equivalent effects on ciliary muscle paralysis in myopic children, and has higher security. Cyclopentolate could replace atropine for myopic children before optometry.

Availability of Cycloplegic Refraction in Children and Adolescents

PURPOSE: To compare non-cycloplegic and cycloplegic refractive errors and evaluate the utility of cycloplegia in Korean children and young adolescents.METHODS: An anterospective study including 406 outpatients was conducted from September 2015 to December 2017. Pre and post-cycloplegic refractive errors for both eyes were measured using Ocucyclo® and Mydrin P® with an auto-refractor. Patients were divided into different groups according to age: group 1 (< 4 years), group 2 (4–6 years), group 3 (6–8 years), group 4 (8–10 years) and group 5 (< 20 years).RESULTS: A total of 203 patients were studied. Standard deviation (sphere post-pre) was 1.26 ± 1.02 diopters significant in all age groups (p < 0.05). The mean difference decreased with increasing age (r = 0.207, p < 0.05), however, 9% of group with age greater than 10 years old still had manifest refraction-cycloplegic refraction (MR-CR) difference greater than 2 diopters. There were no significant cylindrical or axial component value difference before and after cycloplegia (p = 0.071). Significantly greater MR-CR differences were observed in hypermetropes ≥ 6 years old and myopes ≤8 years old (p < 0.05). The prevalence of pre-cycloplegic eyes with anisometria was 22.6% and 32.6%, a total of 7.39% regressed after cycloplegia (p > 0.05).CONCLUSIONS: After CR hyperopic shift was observed in all age groups. In patients with age greater than 10 years old, although statistically not significant, anisometropia and pseudomyopia still existed. Thus cycloplegic refraction should be performed in young adolescent to precisely measure and correct refractive error and avoid overcorrection.

Variant myopia: A new presentation?

Purpose: Variant myopia (VM) presents as a discrepancy of >1 diopter (D) between subjective and objective refraction, without the presence of any accommodative dysfunction. The purpose of this study is to create a clinical profile of VM. Methods: Fourteen eyes of 12 VM patients who had a discrepancy of >1D between retinoscopy and subjective acceptance under both cycloplegic and noncycloplegic conditions were included in the study. Fourteen eyes of 14 age- and refractive error-matched participants served as controls. Potential participants underwent a comprehensive orthoptic examination followed by retinoscopy (Ret), closed-field autorefractor (CA), subjective acceptance (SA), choroidal and retinal thickness, ocular biometry, and higher order spherical aberrations measurements. Results: In the VM eyes, a statistically and clinically significant difference was noted between the Ret and CA and Ret and SA under both cycloplegic and noncycloplegic conditions (multivariate repeated measures analysis of variance, P < 0.0001). A statistically significant difference was observed between the VM eyes, non-VM eyes, and controls for choroidal thickness in all the quadrants (Univariate ANOVA P < 0.05). The VM eyes had thinner choroids (197.21 � 13.04 ?) compared to the non-VM eyes (249.25 � 53.70 ?) and refractive error-matched controls (264.62 � 12.53 ?). No statistically significant differences between groups in root mean square of total higher order aberrations and spherical aberration were observed. Conclusion: Accommodative etiology does not play a role in the refractive discrepancy seen in individuals with the variant myopic presentation. These individuals have thinner choroids in the eye with variant myopic presentation compared to the fellow eyes and controls. Hypotheses and clinical implications of variant myopia are discussed.

Evaluation of cycloplegic effectiveness of atropine, cyclopentolate and tropicamide / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the effectiveness of three cycloplegia drugs: atropine, cyclopentolate and tropicamide on school-age children, and provid theoretical basis in choosing cycloplegic drugs for school-age children. <p>METHODS: Totally 420 myopic school-age students(818 eyes)in out-patients department were selected during July to August 2017. Candidates were divided into three medicine groups according to their age: Group A: <8 years old, utilizing 1% atropine; Group B: 8-12 years old, utilizing the cyclopentolate; Group C: >12 years old, utilizing the tropicamide. The difference of refraction degree before and after medicine application were calculated. <p>RESULTS: The coincidence rate of spherical equivalent refraction with cycloplegia and without cycloplegia was 81.0% in atropine group, 81.3% in cyclopentolate group and 79.4% in tropicamide group respectively. There was statistical difference of refraction results of the Group A between with atropine cycloplegia and without cycloplegia. The mean difference was -0.113±0.226D(<i>t</i>=-4.663, <i>P</i><0.001). There was no statistical refraction difference of the Group B between with cyclopentolate cycloplegia and without cycloplegia, the mean difference was -0.025±0.192D(<i>t</i>=-1.665, <i>P</i>=0.099). So does the difference of Group C between with tropicamide cycloplegia and without cycloplegia, which was -0.026±0.193D(<i>t</i>=1.760, <i>P</i>=0.080). <p>CONCLUSION: For children older than 8-years old and without strabismus and amblyopia, cyclopentolate or tropicamide can be used to give cycloplegia refraction for the first time, which is convenient for their daily activities. The cycloplegia refraction results should been re-checked after used atropine, and giving prescription by using the principle of maximum plus to maximum visual acuity(MPMVA).

Cycloplegic Refraction in Hyperopic Children: Effectiveness of a 0.5% Tropicamide and 0.5% Phenylephrine Addition to 1% Cyclopentolate Regimen

PURPOSE: To evaluate the effectiveness of a cycloplegic regimen using 0.5% tropicamide and 0.5% phenylephrine (Tropherine, Hanmi Pharm), in addition to 1% cyclopentolate, in hyperopic children. METHODS: The medical records of hyperopic patients below the age of 14 years who had undergone cycloplegic retinoscopy were retrospectively reviewed. Cycloplegic refractions were performed using one of two cycloplegic regimens. Regimen 1 was a Tropherine-added regimen comprising the administration of one drop of 1% cyclopentolate followed by two to three drops of Tropherine added at 15-minute intervals. Regimen 2 was a cyclopentolate-only regimen comprising the administration of three to four drops of 1% cyclopentolate at 15-minute intervals. The mean difference between noncycloplegic and cycloplegic refraction was compared between the two regimens. RESULTS: A total of 308 eyes of 308 hyperopic children were included. The mean difference (±standard deviation) in the spherical equivalent (SE) between cycloplegic and noncycloplegic refraction was significantly larger in regimen 2 than in regimen 1, with values of +1.70 ± 1.03 diopters (D) and +1.25 ± 0.89 D, respectively (p=0.001). The SE change after cycloplegia was significantly different between the two regimens only in patients aged 5 years or younger (p=0.001), particularly in those with high hyperopia with an SE ≥5 D (p=0.005) or fully accommodative esotropia (p=0.009). There was no significant difference between the two regimens in patients older than 5 years, regardless of the presence of high hyperopia or fully accommodative esotropia. CONCLUSIONS: The Tropherine-added regimen exerted a weaker cycloplegic effect than the cyclopentolate-only regimen, particularly in children under the age of 5 years with high hyperopia or fully accommodative esotropia. However, the difference in refraction between the two regimens was small. A Tropherine-added regimen can be effective in hyperopic children, with less associated discomfort than the instillation of cyclopentolate.

Comparison of Manifest Refraction and Cycloplegic Refraction Using Retinoscopy or an Autorefractor in Children

PURPOSE: To compare the measurements between manifest refraction and cycloplegic refraction using retinoscopy or an autorefractor in children and to investigate factors affecting the difference. METHODS: A total of 388 children with a mean age of 7.4 ± 3.6 years were examined using retinoscopy and a Grand Seiko GR-3500KA autorefractor before and after cycloplegia. We compared the difference in spherical and cylindrical components between refractions and analyzed the results according to gender, age, type of refractive error, amblyopia, strabismus, and neuro-developmental disorder. A difference in refractions of ±0.50 D or more was considered as a significant discrepancy. RESULTS: Before cycloplegia, the spherical portion of the refractive error via autorefractor measurement was more myopic than for the retinoscopic measurement in 47.2% of patients, and the cylindrical portion was greater in 37.1%. The spherical discrepancies were more common in children aged < 7 years, with hyperopia, or amblyopia (respectively, p = 0.002, p < 0.001, and p = 0.033). After cycloplegia, the spherical component of the refractive error by auto-refraction differed from retinoscopic measurement in 29.4% of patients, and the cylindrical portion differed in 30.7%. However, the difference was not significant and there was no difference according to clinical features. More than half of the children with discrepancies in the spherical component between retinoscopic refractions before and after cycloplegia had a discrepancy between auto-refraction and retinoscopic refraction before cycloplegia, and the two discrepancies had a significant correlation. CONCLUSIONS: Auto-refraction after cycloplegia can estimate retinoscopic values partially. Nevertheless, 30% of the children still showed a discrepancy. The discrepancy of manifest refraction or auto-refraction compared to retinoscopic refraction with cycloplegia should be considered in younger children, cases with hyperopia or amblyopia, and cases with a difference in auto-refraction and retinoscopic refraction before cycloplegia.

Side Effects after the Use of Cyclopentolate for Cycloplegic Refraction

PURPOSE: To investigate the frequency of side effects due to the use of cyclopentolate for cycloplegic refraction. METHODS: For 4 months, temperature change and adverse effects in 157 children who visited the pediatric ophthalmology clinic of a university hospital for cycloplegic refraction using cyclopentolate were observed. Topical 1% cyclopentolate was instilled 5 times at 5 minute intervals and temperature measured before and after administration using a tympanic thermometer. Side effects such as facial flushing, skin rash, and central nervous system disorders were recorded while cycloplegic refraction was performed. RESULTS: The mean temperature was increased 36.67 +/- 0.10degrees C to 36.90 +/- 0.09degrees C, but no fever exceeded 38degrees C. Seventeen (10.83%) patients experienced side effects including facial flushes (n = 6), temperature change (n = 5), abnormal central nervous system symptoms (n = 4), and a visible skin rash (n = 2). No patient experienced more than 1 side effect and long term adverse effects were not observed. CONCLUSIONS: The incidence of side effects due to cyclopentolate instillation for cycloplegic refraction was 10.83% in children. Although side effects due to cyclopentolate disappeared without any treatment, cafeful monitoring for their occurrence is necessary.

Comparison of cyclopentolate and atropine on cycloplegia in children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effectiveness on 10g/L cyclopentolate and 10g/L atropine on cycloplegia in children before optometry. METHODS:Eighty eyes of 40 children among 4-12 years old with refractive error were recruited in this study. 10g/L cyclopentolate eye drops were topically administered once per 5min for 3 times and optometry was performed after 45min. Three days after that, 10g/L atropine sulfate eye gel then was used 3 times per day for consecutive 3d and again the refractive diopter was obtained at the 4th d. The differences of the results in retinoscopy refraction were compared between 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel. RESULTS: Therefraction results of those given 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel were no statistical different in both 4-8 years group and 9-12 years group with myopia (≤-3. 00D) (P=0. 411, 0. 924). The differences of refraction results of both the drugs were significant in 4 - 8 years group with low hypermetropia, medium hypermetropia and high hypermetropia (P=0. 007, 0. 007, 0. 009). No significant difference was found in 9 - 12 years group with low hypermetropia (P= 0. 592), given 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel, but the differences of refraction results of both the ophthalmic preparations above were significant in 9-12 years group with medium and high hypermetropia (P=0. 039, 0. 012). CONCLUSION:Both 10g/L cyclopentolate eye drops and 10g/L atropine sulfate eye gel have the cycloplegic effects, but their cycloplegic effects are significant different among hypermetropia children. Thus, the reasonable cycloplegic should be chosen according to the specific situation.

Reliability and Usefulness of Refractive Measurements by PlusoptiX S09 in Children

PURPOSE: To compare the refractive measurements obtained using a photorefractor (PlusoptiX S09, PlusoptiX GmbH, Germany) with those obtained using cycloplegic refraction in children. METHODS: We assessed the refractive status of 268 eyes in 134 children. The values acquired via photorefraction with a PlusoptiX S09 device were compared with those obtained by cycloplegic retinoscopy. Hyperopia (> or =+3.5 D), myopia (> or =-3.0 D), with the rule or against the rule astigmatism (> or =-1.5 D), and oblique astigmatism (> or =-1.0 D) were set as diagnostic criteria for refractive amblyopia risk factors (RARFs). The difference in the detection of RARFs by the two methods was the main outcome measure. RESULTS: The average spherical refractive power was -0.81 +/- 1.68 D for PlusoptiX S09 versus -0.26 +/- 2.00 D for cycloplegic retinoscopy (average difference -0.54 +/- 0.61 D; p < 0.001). The average spherical equivalent was -1.20 +/- 1.62 D for PlusoptiX S09 versus -0.64 +/- 1.94 D for cycloplegic retinoscopy (average difference -0.56 +/- 0.62 D; p < 0.001). The average cylinder power was -0.79 +/- 0.93 D for PlusoptiX S09 versus -0.76 +/- 0.94 D for cycloplegic retinoscopy (average difference -0.03 +/- 0.33 D; p = 0.135). Even though cycloplegic retinoscopy is considered the gold standard, the sensitivity and specificity for detecting RARFs with the PlusoptiX S09 were 88.0% and 96.3%, respectively. CONCLUSIONS: PlusoptiX S09 is a relatively useful method for detecting RARFs, but the device tends toward myopic shift compared to cycloplegic refraction, and hyperopia is underestimated.

Transient Myopic Shift Due to Increased Latent Accommodation after LASEK

PURPOSE: To investigate accommodation and progress of patients who showed myopia on manifest refraction in the early postoperative period after LASEK. METHODS: Forty-one eyes were included in the present study which had undergone LASEK surgery from February to March 2012. Seven eyes showed myopia over -0.25 D on manifest refraction at 1 month postoperatively, but showed decreased amount of myopia at 2 months postoperatively and were classified as group 1. The other 34 eyes were classified as group 2. The differences between cycloplegic and manifest refraction (CRSE-MRSE) were defined as the amount of latent accommodation and compared between the 2 groups. RESULTS: Amount of latent accommodation was 0.179 +/- 0.426 D in group 1 (7 eyes), 0.265 +/- 0.303 D in group 2 (34 eyes) preoperatively, 1.286 +/- 0.664 D in group 1, 0.368 +/- 0.536 D in group 2 at 1 month postoperatively, and 0.500 +/- 0.520 D in group 1, and 0.489 +/- 0.546 D in group 2 at 2 months postoperatively. The amount of latent accommodation in group 1 was significantly greater than that of group 2 one month postoperatively. As the amount of latent accommodation decreased, the amount of myopic shift decreased gradually over 2 months in group 1 after surgery. CONCLUSIONS: Transient myopic shift due to increased latent accommodation was observed in several patients one month postoperatively and the amount of myopic shift decreased with time without treatment. Thus, surgeons should consider cycloplegic refraction when planning treatment for patients with myopic regression.

Evaluation of cycloplegic effectiveness of cyclopentolate and atropine / 中华实验眼科杂志

BackgroundCycloplegia is well accepted for the first refraction estimate in childhood.Yet no good evidence is offered in terms of which cyclopegia is preferable for the different ages and refractive status in children. ObjectiveThis study aimed to compare the effectiveness of cycloplegia between 1％ cyclopentolate and 1％ atropine sulphate before optometry in ametropia children. Methods This was a prospective clinical trail.The self matched-pairs control randomly observation was designed.One hundred and sixty eyes of 80 children of 4-9 years old with refractive error were recruited in this study.1％ cyclopentolate eye drops were topically administered once per 5 minutes for 3 times and 1％optometry was performed 45 minutes after eye dropping.Three days after that,1％ atropine then was used 3 times per day for consecutive 3 days and again the refractive diopter was obtained.The differences of the results in autorefraction,retinoscope and residual accommodation were compared between 1％ cyclopentolate and 1％atropine eye drops.This trail was approved by the Ethic Committee and written informed consent was obtained from each custodian. Results The autorefraction values were ( 0.55 ±3.52 ) D and ( 2.22 ±3.52) D before and after the administration of 1％ atropine with the difference value( 1.66± 1.62) D (t =13.02,P =0.00 ).The autorefraction value was( 1.74±3.46 ) D after dropping of 1％ cyclopentolate and the difference value from that of 1％ atropine was (0.48 ± 0.46) D ( t =13.08,P =0.00 ).The cy(e)lplegic autorefractions of atropine and cyclopentolate have strong correlation ( R2 =0.98,P =0.000 ).The residual accommodation values were ( 0.32± 0.44 )D and(0.05±0.41 ) D after dropping of 1％ cyclopentolate and 1％ atropine with the difference( 0.27±0.55 ) D ( t =4.56,P =0.00 ).The difference value of refractive diopter was (0.31 ± 0.37 )D in myopic group,(0.56±0.48 )D in moderate hypermetropic group and(0.59±0.50)D in high myopic group,and that of myopic group was significantly lower than the moderate hypermetropic group ( t =- 3.14,P =0.00 ).No significant difference was found in the autorefraction difference between 4-6 years group and 7 -9 years group [ ( 0.61 ±0.53 ) D vs ( 0.49 ±0.39 ) D ] ( t =1.21,P=0.23 ).The hidden value because of accommodation had weak correlation with the difference value between atopine and cyclopentolate(r=0.43,P=0.00). ConclusionsBoth 1％ atropine and 1％ cyclopentolate have the cycloplegic effects.This study suggestes that 1％ atropine should be used for the optometry of hypermetropia children.

Optimal dosage of cyclopentolate 1% for cycloplegic refraction in hypermetropes with brown irides.

To find the optimal dosage of cyclopentolate 1% for cycloplegic refraction in hypermetropes with brown irides, we investigated the difference in cycloplegic auto-refractions obtained after one, two, and three instillations in the same patient. The mean hypermetropia found after three instillations was statistically significantly more compared to that found after one instillation. There was no statistically significant difference in the mean hypermetropia between two and three instillations. There was no significant effect of gender, age, and the presence and type of horizontal deviation. These observations suggest that two drops of cyclopentolate 1% 10 min apart are sufficient for cycloplegic refraction in hypermetropes.

Topical tropicamide induced delirium and psychosis: case report / Delírio e psicose induzidos por tropicamida tópica: relato de caso

Acute psychosis and confusional states are known complications of treatment with anticholinergic agents in the elderly. We report an 87-year-old female patient presenting with acute neurobehavioral abnormalities requiring hospitalization immediately after starting treatment for openangle glaucoma with the topic cycloplegic muscarinic receptor blocker tropicamide. Case-effect relationship was confirmed. The authors make a review of the literature trying to identify the clinical manifestations and risk factors for this complication.

Tratamento com drogas anticolinérgicas é uma causa conhecida de alterações agudas do estado mental em idosos. Relata-se o caso de uma paciente de 87 anos de idade com alterações comportamentais agudas, que necessita de internamento imediatamente após início de terapia para glaucoma de ângulo aberto com tropicamida, um agente cicloplégico bloqueador de receptor muscarínico. A relação causa-efeito foi confirmada depois de a droga ter sido reiniciada durante o internamento. É apresentada uma revisão da literatura delineando as manifestações clínicas mais comuns e fatores de risco para essa complicação.

Two Cases of Topiramate-induced Acute Myopia

PURPOSE: We describe 2 cases of bilateral acute myopia associated with topiramate, a drug that has recently been prescribed for epilepsy or weight reduction. CASE SUMMARY: A 24-year-old woman and a 25-year-old woman, both previously devoid of ocular problems, visited our hospital with blurry vision after taking topiramate for weight reduction. A thorough medical history review and ocular examinations, including a slit lamp examination, were performed. CONCLUSIONS: Slit-lamp examinations revealed forward displacement of the lens-iris diaphragm, which resulted in myopia and anterior chamber shallowing. Discontinuation of topiramate and the administration of cycloplegic agents successfully resolved the symptoms.

A Case Report on the Change of the Refractive Power After a Blunt Trauma

PURPOSE: To determine the pathogenesis of transient myopia after blunt eye trauma. METHODS: In one patient, the refraction of both eyes (the left eye was injured, but the right eye was not) was measured with an autorefractometer. The cycloplegic refraction was measured at the early stage of trauma and again 3 months after the blunt eye injury. The angle and depth of the anterior chamber, the ciliary body, and the choroids were examined by ultrasound biomicroscopy (UBM) over 3 months. The depth of the anterior chamber, the thickness of the lens, and the axial length were measured by A-scan ultrasonography in both eyes. During the 3 months after the injury, we made comparisons between the menifest and the cycloplegic refractions, the depths of anterior chambers, the thickness of the lenses, the axial lengths, and the UBM-determined appearances of the angles and depths of the anterior chambers, the ciliary bodies, and the choroids in both eyes. RESULTS: We suspect that the depth reduction in the anterior chamber, the increase in anterior to posterior lens diameter, and the edema in the ciliary body are all related to the change in the refractive power following the blunt trauma. CONCLUSIONS: Ultrasound biomicroscopy (UBM) and ultrasonography of the anterior segment in the eye may be helpful to diagnose and confirm changes in the refractive power that occur after trauma.

A Case Report on the Change of the Refractive Power After a Blunt Trauma

PURPOSE: To determine the pathogenesis of transient myopia after blunt eye trauma. METHODS: In one patient, the refraction of both eyes (the left eye was injured, but the right eye was not) was measured with an autorefractometer. The cycloplegic refraction was measured at the early stage of trauma and again 3 months after the blunt eye injury. The angle and depth of the anterior chamber, the ciliary body, and the choroids were examined by ultrasound biomicroscopy (UBM) over 3 months. The depth of the anterior chamber, the thickness of the lens, and the axial length were measured by A-scan ultrasonography in both eyes. During the 3 months after the injury, we made comparisons between the menifest and the cycloplegic refractions, the depths of anterior chambers, the thickness of the lenses, the axial lengths, and the UBM-determined appearances of the angles and depths of the anterior chambers, the ciliary bodies, and the choroids in both eyes. RESULTS: We suspect that the depth reduction in the anterior chamber, the increase in anterior to posterior lens diameter, and the edema in the ciliary body are all related to the change in the refractive power following the blunt trauma. CONCLUSIONS: Ultrasound biomicroscopy (UBM) and ultrasonography of the anterior segment in the eye may be helpful to diagnose and confirm changes in the refractive power that occur after trauma.

The effect of cyclopentolate cycloplegic on the refraction measurement in adult guinea pigs / 眼科

Objective To investigate the effect of cyclopentolate cycloplegic on the refraction measurement in adult guinea pigs. Design Experimental study.Participants 24 eyes of 12(10 weeks) adult guinea pigs.Methods 12 animals were randomly examined thrice by streak retinoscopy pre and post mydriasis.1%cyclopentolate hydrochloride was topically administrated to the eye every five minutes for three times.Main Outcome Measures The eye refraction of guinea pigs included the scope,cylinder and the equivalent power.Results The average refraction of guinea pigs in pre-mydriasis and post-mydriasis were 1.92?0.79 D and 2.08?0.79 D respectively. The average refraction that included the scope,cylinder and the equivalent power all showed no significant difference between pre and post mydriasis.The effect of mydriasis and measure time points on the refraction that included the scope,cylinder and the equivalent scope showed no significant difference either.Conclusions The effect of 1%cyclopentolate cycloplegic on adult guinea pigs in refraction is limited.The refraction of adult guinea pig can be measured naturally without cyclopentolate cycloplegic administrated.

Clinical Comparison of Autorefractor versus Retinoscopic Refraction in Children according to the Age

PURPOSE: We analyzed the difference in values between noncycloplegic and cycloplegic autorefraction and refraction, as measured by ophthalmologist, in children according to age. METHODS: We classified the 84 children (153 eyes) whose best corrected visual acuity was better than 0.6 into four groups according to age. The first age group ranged from 29 to 57 months (36 eyes); the second age group ranged from 58 to 75 months (47 eyes); the third age group ranged from 76 to 95 months (36 eyes); and the fourth age group ranged from 96 to 121 months (34 eyes). The children were examined with an autorefractometer (Canon Auto Ref RK-2) and a retinoscope before and after cycloplegia. RESULTS: The children in all age groups tend to show more myopia in autorefraction than refraction regardless of cycloplegia. Also, differences in spherical component and spherical equivalents in noncycloplegic autorefraction and cycloplegic refraction were regarded as significant statistically (P<0.05) in all age groups. However, in all groups, none of the refractive values in cycloplegic autorefraction and refraction were statistically significant. CONCLUSION: Refraction measurement should be recommended for cycloplegic refraction in children. It is suggested that cycloplegic autorefraction could be useful for the refraction partially.

Comparative Research of Cyclopentolate Hydrochlorid,Tropicamide and Atropine / 中国药房

OBJECTIVE:To study clinical efficacy and adverse drug reaction(ADR) of Cyclopentolate hydrochloride eye drops,Tropicamide eye drops and Atropine eye drops.METHODS:600 asthenopic children were divided into 3 groups according to visiting time sequence(n=200).3 groups were treated with 1% Cyclopentolate hydrochloride eye drops,1% Tropicamide eye drops and 1% Atropine eye drops respectively.Mydriasis effects of 3 groups were observed and results of retinoscopy were recorded.Ocular ADR and systemic ADR were surveyed.RESULTS:The level of ocular ADR and systemic ADR of tropicamide group were lower than other 2 groups(P

Refraction before and after LASIK

PURPOSE: It is important to know the accurate refractive error of the patients before LASIK because the amount of ablation is determined by that. We analyzed whether there are differences among the preoperative and postoperative results of cycloplegic retinoscopy (CR), module setting value, and autorefraction with and without cycloplegia (ACR, AMR). METHODS: The manifest and cycloplegic refractions of 104 eyes of 104 patients who underwent LASIK from February 2001 to July 2001 were reviewed. The preoperative and postoperative cycloplegic refraction, autorefraction by Canon RK-5, and module setting value were analyzed. RESULTS: In comparison of the preoperative values, AMR showed myopic shift compared to CR, module setting, and ACR (p<.001). ACR showed hyperopic shift compared to CR (p<0.001). The module setting showed myopic shift compared to CR, but it was not statistically significant. Postoperative mean spherical equivalent was 0.04 +/- 0.67D(range: -1.75 ~ +1.5). In comparison of the postoperative results, ACR showed hyperopic shift compared to CR (p<0.001) and AMR showed myopic shift compared to CR (p<0.001). CONCLUSIONS: As there is a difference between autorefraction and cycloplegic refraction, it is inappropriate to decide the amount of ablation only by one method. Hence when LASIK or LASIK retreatment is planned, cycloplegic refraction as well as autorefraction is necessary.