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Comparing keratometry readings with manual separation of lids and wire speculum in children under general anesthesia
Jitendra Jethani1, Kavita Porwal2, Amit Porwal2
1Baroda Children Eyecare and Squint Clinic, Vadodara, Gujarat, India.
Insights
Accurate keratometry (K) readings are essential for cataract surgery lens calculations. This study found no significant difference in K readings between manual eyelid separation and speculum use in children under anesthesia, ensuring reliable measurements.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Surgical Technology
Background:
- Keratometry (K) readings are vital for intraocular lens power calculation in cataract surgery.
- Accurate K readings in non-cooperative children typically require general anesthesia.
- Current methods for eyelid retraction during K measurement under anesthesia lack consensus.
Purpose of the Study:
- To compare the reliability of keratometry readings in children under general anesthesia using two different eyelid retraction methods.
- To determine if manual eyelid separation or wire speculum use affects K readings.
Main Methods:
- Keratometry readings were obtained from cooperative children in the outpatient department (OPD) while awake.
- Under general anesthesia, K readings were measured using a handheld autokeratometer with manual eyelid separation.
- Subsequently, K readings were taken after placing a wire speculum for eyelid separation.
Main Results:
- The average keratometry readings were 44.7 ± 1.7 D (OPD, awake), 44.4 ± 1.9 D (anesthetized, manual separation), and 44.7 ± 1.7 D (anesthetized, speculum).
- Statistical analysis revealed no significant differences in K values among the three measurement conditions.
Conclusions:
- Neither manual eyelid separation nor the use of a wire speculum significantly alters keratometry values in children under general anesthesia.
- Both methods are reliable for obtaining K readings in pediatric patients requiring anesthesia for accurate intraocular lens power calculations.
Purpose:
Keratometry (K) readings are crucial for intraocular lens power calculation in cataract surgery. In children who do not cooperate, the keratometry is done under general anesthesia with a handheld autokeratometer. However, there is little consensus regarding the method for the measurement of K readings. The lids can be separated either by fingers or a wire speculum may be placed to separate the lids for measurement.
Methods:
The children selected for the study were patients cooperative for keratometry reading. Nidek KM-500 handheld keratometer was used first in the awake period. Then under general anesthesia, readings were taken first by separating the lids manually with fingers and then after putting a wire speculum in both the eyes.
Results:
The average keratometry reading for participants in the OPD, anesthetized with lids manually opened and with lids separated with speculum was 44.7 ± 1.7 D, 44.4 ± 1.9 D, and 44.7 ± 1.7 D, respectively.
Conclusion:
No significant change was observed in keratometry values in children with manual separation of eyelids or with wire speculum.
