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Takahiro Hiraoka, Kazunori Miyata, Fumiki Okamoto, Tetsuro Oshika; Influences of cycloplegia with topical cyclopentolate on higher-order aberrations in myopic children. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4255.
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It is little known about the effect of cycloplegia with topical cyclopentolate on optical quality of the eye in myopic children. We conducted this prospective study to investigate the influence of topical cyclopentolate on higher-order aberrations (HOAs) in myopic children.
Twenty-eight eyes of 28 myopic children (17 boys and 11 girls), ranging in age from 4 to 12 years (7.25 ± 2.55, mean ± standard deviation), were enrolled in this study. We evaluated refraction and wavefront aberrations before and after cycloplegia with topical instillation of 1% cyclopentolate hydrochloride. Ocular and corneal aberrations were simultaneously measured and compared with each other. Individual Zernike components were also analyzed for a 6-mm pupil up to the sixth order. All these parameters were compared before and after cycloplegia. In addition, the obtained data were compared with other 23 subjects with hyperopia.
Cycloplegia with topical cyclopentolate induced significant hyperopic changes from -3.07 ± 2.23 to -2.57 ± 2.15 D (P < 0.001, paired t-test). Ocular higher-order aberrations (HOAs) increased significantly from 0.243 ± 0.111 to 0.263 ± 0.105 μm for coma-like aberrations (P = 0.042), from 0.124 ± 0.041 to 0.138 ± 0.037 μm for spherical-like aberrations (P = 0.012), and from 0.279 ± 0.105 to 0.304 ± 0.096 μm for total HOAs (P = 0.015). Corneal HOAs did not change by cycloplegia. When corneal and ocular HOAs were compared, the ocular HOAs were significantly smaller than the corneal HOAs in spherical-like aberrations (P < 0.001) and total HOAs (P = 0.006). When compared between myopic and hyperopic children, spherical-like aberrations and total HOAs were significantly larger in hyperopia than in myopia (P = 0.001 and P = 0.042, unpaired t-test). However, each Zernike component showed a large standard deviation in both groups.
Internal optics compensate for corneal HOAs also in myopic children, and paralysis of tonic accommodation with cyclopentolate considerably affects ocular HOAs. It may be that physiological tonic accommodation is done to improve retinal image quality by reducing HOAs. In addition, HOAs tend to be smaller in myopia than in hyperopia, but inter-individual variation in each Zernike component is quite large in both myopic and hyperopic children.
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