Influences of cycloplegia with topical atropine on ocular higher-order aberrations.

Abstract

To investigate the influence of cycloplegia with topical atropine on higher-order aberrations (HOAs) of the eye in children. Prospective, noncomparative study. Twenty-three eyes of 23 subjects (11 boys and 12 girls) with hyperopia, ranging in age from 3 to 12 years (average, 5.74 years), were enrolled in this study. Refraction and wavefront aberration were evaluated before and after cycloplegia with topical instillation of 1% atropine solution administered twice daily for 1 week. Ocular and corneal HOAs were measured simultaneously, and individual Zernike components were analyzed for a 6-mm pupil up to the 6th order. All these parameters were compared before and after cycloplegia. Ocular and corneal HOAs before and after cycloplegia. Cycloplegia with topical atropine significantly increased spherical equivalent refraction from +1.92±1.53 diopters (D) to +3.10±1.61 D (P<0.01, paired t test). Ocular HOAs significantly increased from 0.282±0.086 μm to 0.316±0.087 μm for coma-like aberrations (P=0.02), from 0.169±0.058 μm to 0.192±0.076 μm for spherical-like aberrations (P=0.02), and from 0.333±0.093 μm to 0.377±0.095 μm for total HOAs (P=0.01). Corneal HOAs did not change after cycloplegia. As for individual Zernike components, significant changes were found in C3(1) and C4(0) after cycloplegia (P<0.05). The induced changes in C4(0) were correlated significantly with those in spherical equivalent refraction (Pearson's correlation coefficient, R=0.45; P=0.03). Cycloplegia with atropine induced significant hyperopic shift and increases in ocular HOAs in children, leading to reduction in optical quality of the eye. It may be that physiologic tonic accommodation plays a role in improving retinal image quality by decreasing HOAs and refractive errors. The author(s) have no proprietary or commercial interest in any materials discussed in this article.