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Refraction under general anesthesia in children, using cycloplegic refraction only as a reference

Osman Bulut Ocak1, Asli Inal1, Beril Tülü Aygün1

  • 1Beyoglu Eye Training and Research Hospital, University of Health Sciences , Istanbul.

Strabismus
|January 28, 2020
PubMed

Insights

Pediatric refractive measurements under general anesthesia (GA) were more myopic than cycloplegic refraction. This highlights that GA does not achieve complete cycloplegia, impacting auto-refractometer (ARF) readings.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Refractive Error Assessment

Background:

  • Accurate refractive error assessment is crucial for pediatric eye care.
  • General anesthesia (GA) is sometimes necessary for pediatric eye examinations.
  • The impact of GA on auto-refractometer (ARF) readings requires careful consideration.

Purpose of the Study:

  • To compare pediatric refractive measurements obtained via auto-refractometer (ARF) under general anesthesia (GA) with those from cycloplegic refraction.
  • To evaluate the agreement and correlation between these two measurement methods.

Main Methods:

  • A study included 222 pediatric patients (36-60 months) undergoing ARF (Retinomax® K plus 3) under GA.
  • Cycloplegic refraction using 1% cyclopentolate and the same ARF device was performed within 3 months prior to GA.
  • Bland-Altman analysis and Pearson correlation were used to analyze measurement agreement and correlation.

Main Results:

  • A strong positive correlation (r=0.95) was found between GA and cycloplegic refraction measurements.
  • Refractive measurements under GA were significantly more myopic (-1.49 D) than cycloplegic refraction.
  • Differences were within ±1 D in 41.44% and within ±2 D in 81.01% of eyes; no significant difference in cylindrical error.

Conclusions:

  • Pediatric refractive measurements under GA tend to be more myopic compared to cycloplegic refraction.
  • General anesthesia does not induce complete cycloplegia, influencing autorefractor readings.
  • Clinicians should be aware of these differences when interpreting ARF data obtained under GA.
Abstract

Keywords:
Accommodationcycloplegiageneral anesthesiarefraction

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