METHODS: A prospective cross-sectional study evaluated a cohort of 96 paediatric patients that underwent ophthalmologic examination. An optometrist performed two repeated measurements of autorefraction and biometry pre- and post-cycloplegia. Test-retest repeatability (TRT) was assessed as differences between consecutive measurements and agreement as differences between post- and pre-cycloplegia measurements, for spherical equivalent (SE), refractive and keratometric J0/J45 astigmatic components, mean keratometry (Km) and axial length (AL).
RESULTS: Cycloplegia significantly improved the SE repeatability (TRT, pre-cyclo: 0.65 D, post-cyclo: 0.31 D). SE measurements were more repeatable in myopes and emmetropes compared to hyperopes. Keratometry (Km) repeatability did not change with cycloplegia (TRT, pre-cyclo: 0.25 D, post-cyclo:0.27 D) and AL repeatability improved marginally (TRT, pre-cyclo: 0.14 mm, post-cyclo: 0.09 mm). Regarding pre- and post-cycloplegia agreement, SE became more positive by + 0.79 D, varying with refractive error. Myopic eyes showed a mean difference of + 0.31 D, while hyperopes differed by + 1.57 D. Mean keratometry, refractive and keratometric J0/J45 and AL showed no clinically significant differences.
CONCLUSIONS: Refractive error measurements, using the Myopia Master were 2.5x less precise pre-cycloplegia than post-cycloplegia. Accuracy of pre-cycloplegic refractive error measurements was often larger than the clinically significant threshold (0.25 D) and was refractive error dependent. The higher precision compared to autorefraction measurements, pre- and post-cycloplegia agreement and refractive error independence of AL measurements emphasize the superiority of AL in refractive error monitoring.
方法:一项前瞻性横断面研究评估了96名接受眼科检查的儿科患者的队列。验光师在睫状肌麻痹前后进行了两次自屈光和生物测量的重复测量。重测可重复性(TRT)被评估为连续测量之间的差异,并且一致性被评估为后和前睫状肌麻痹测量之间的差异。对于球形当量(SE),屈光和角膜曲率J0/J45散光分量,平均角膜曲率(Km)和轴向长度(AL)。
结果:截肢药显着提高了SE可重复性(TRT,预循环:0.65D,循环后:0.31天)。与远视眼相比,SE测量在近视和近视眼中更可重复。角膜角化术(Km)的可重复性没有随着睫状肌麻痹而改变(TRT,预循环:0.25D,循环后:0.27D)和AL重复性略有提高(TRT,预循环:0.14毫米,循环后:0.09毫米)。关于睫状肌麻痹前后的协议,SE在+0.79D时变得更积极,随着屈光不正而变化。近视眼表现出+0.31D的平均差,而远位相差+1.57D。平均角膜曲率测量,屈光和角膜曲率J0/J45和AL没有临床显着差异。
结论:折射率测量,使用近视Master的睫状肌麻痹前的精确度比睫状肌麻痹后的精确度低2.5倍。睫状肌麻痹前屈光不正测量的准确性通常大于临床上的显着阈值(0.25D),并且与屈光不正有关。与自动折射测量相比,精度更高,眼肌麻痹前后的一致性和AL测量的屈光不正独立性强调了AL在屈光不正监测中的优越性。