title: Influence of mydriatic eye drops on wavefront sensing with the Zywave aberrometer.
abstract: OBJECTIVE
  To investigate a potential influence of mydriatic eye drops on wavefront sensing with the Zywave aberrometer (Technolas Perfect Vision) in terms of predicted phoropter refraction (PPR) and higher order aberrations (HOA).
  
  
  METHODS
  In this prospective study, 200 myopic eyes were measured in miosis and pharmacologically induced mydriasis with an aberrometer and automated refraction. One hundred eyes were dilated with tropicamide 0.5%+phenylephrine 2.5% eye drops (tropicamide/phenylephrine group), and the remaining 100 eyes with tropicamide 0.5% (tropicamide only group). The PPR values for a pupil diameter of 3.5 mm in miosis and mydriasis, respectively, were compared and correlated to the corresponding values of automated refraction. Changes in HOAs up to the 4th order were recorded.
  
  
  RESULTS
  Predicted phoropter refraction values obtained in mydriasis were less myopic than in miosis. The spherical equivalent refraction of PPR differed by an average of 0.36 ± 0.36 diopters (D) in the tropicamide/phenylephrine group. In the tropicamide only group, the difference was 0.24 ± 0.43 D. Sphere of PPR differed by an average of 0.33 ± 0.36 D in the tropicamide/phenylephrine group and by an average of 0.24 ± 0.35 D in the tropicamide only group. Patient age had no major influence on the level of difference. Automated refraction yielded a smaller difference in spherical equivalent refraction. Changes in HOA root-mean-square were statistically significant.
  
  
  CONCLUSIONS
  The cycloplegic effect of mydriatic eye drops should be taken into account when interpreting aberration measurements and planning a wavefront-guided ablation. Ideally, the use of mydriatic eye drops should be avoided to minimize refractive surprises.
authors: Zentrum fur Refraktive Chirurgie, Munster, Germany. taneri@refraktives-zentrum.de
authors: Suphi
authors: S
authors: Taneri
authors: Saskia
authors: S
authors: Oehler
authors: Dimitri T
authors: DT
authors: Azar
mesh_terms: D057128:Aberrometry; D000328:Adult; D057108:Corneal Wavefront Aberration / Q000503:physiopathology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009184:Mydriatics / Q000008:administration & dosage*; D009216:Myopia / Q000503:physiopathology; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D010656:Phenylephrine / Q000008:administration & dosage*; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*; D012029:Refraction, Ocular / Q000502:physiology*; D014331:Tropicamide / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D014331:Tropicamide