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Research article
Takeshi Teshigawara
Yokosuka Chuoch Eeye Clinic
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8264-101X
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Background: We investigated the effect of pupil dilation on predicted postoperative refraction (PPR) and recommended intraocular lens (IOL) power calculated using three different generations of IOL power calculation formulas: Barrett Universal II (Barrett) (new generation), Haigis (4th generation), and SRK/T (3rd generation). Methods: This retrospective study included 150 eyes. All variables were measured and calculated using a ZEISS IOL Master 700. The following variables were measured before and after dilation: anterior chamber depth (ACD), lens thickness (LT), white-to-white (WTW). PPR and recommended IOL power were calculated by Barrett, Haigis, and SRK/T IOL calculation formulas. The change in each variable before and after dilation, and correlations between all changes were analyzed using the Wilcoxon signed-rank test and the Spearman’s rank-order correlation test, respectively. The influence of pupil dilation on recommended IOL power calculated by each formula was also analyzed. Results: The mean absolute change (MAC) in PPR before and after dilation was highest in Barrett, followed by Haigis and SRK/T. Significant differences were found among each MACs (P < 0.0001). Significant changes were observed before and after dilation in ACD and LT (P < 0.0001) but not in WTW. In Barrett and Haigis, there was a significant positive correlation between change in PPR and change in ACD (P < 0.0001) and a negative correlation between change in PPR and change in LT (P < 0.0001). Correlations were strongest in Barret followed by Haigis, especially in LT. Change in PPR in Barrett also demonstrated a significant positive correlation with change in WTW (P = 0.022). The recommended IOL power using Barrett and Haigis changed before and after dilation in 23.3% and 19.3% cases; SRK/T showed no change. Conclusions: In PPR and recommended IOL power, pupil dilation influenced Barrett most strongly, followed by Haigis and SRK/T. Given the stronger correlation between the change in PPR in Barrett and the change in ACD, LT, and WTW, the change of ACD, LT, and WTW is more important to the influence of dilation on Barrett. The influence of dilation on each formula and variable, including ACD, LT, and WTW, is key to improving IOL calculation.
Keywords
anterior chamber depth, Barrett, Haigis, intraocular lens, lens thickness, predicted postoperative refraction, pupil dilation, SRK/T, white-to-white
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CURRENT STATUS: Published
View the published article at BMC Ophthalmology.
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Posted 24 Jan, 2020
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Editorial decision: Major revision
On 22 Apr, 2020
Review #1 received
Received 06 Apr, 2020
Review #2 received
Received 01 Apr, 2020
Reviewer #2 agreed
On 26 Mar, 2020
Reviewer #3 agreed
On 26 Mar, 2020
Reviewer #4 agreed
On 26 Mar, 2020
Reviewer #1 agreed
On 01 Feb, 2020
Reviewers invited
Invitations sent on 31 Jan, 2020
Editor assigned
On 24 Jan, 2020
Editor invited
On 23 Jan, 2020
Submission checks complete
On 22 Jan, 2020
No comments provided
Reviewer #2 agreed
On 27 Dec, 2019
Review #2 received
Received 27 Dec, 2019
Editorial decision: Major revision
On 27 Dec, 2019
Review #1 received
Received 29 Nov, 2019
Reviewers invited
Invitations sent on 22 Nov, 2019
Reviewer #1 agreed
On 22 Nov, 2019
Editor assigned
On 14 Nov, 2019
Submission checks complete
On 07 Nov, 2019
Editor invited
On 05 Nov, 2019
First submitted
On 02 Nov, 2019
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Subject Areas
Ophthalmology
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See the published version of this preprint at BMC Ophthalmology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Takeshi Teshigawara
Yokosuka Chuoch Eeye Clinic
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8264-101X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Ophthalmology.
Version 2
Posted 24 Jan, 2020
No community comments so far
Editorial decision: Major revision
On 22 Apr, 2020
Review #1 received
Received 06 Apr, 2020
Review #2 received
Received 01 Apr, 2020
Reviewer #2 agreed
On 26 Mar, 2020
Reviewer #3 agreed
On 26 Mar, 2020
Reviewer #4 agreed
On 26 Mar, 2020
Reviewer #1 agreed
On 01 Feb, 2020
Reviewers invited
Invitations sent on 31 Jan, 2020
Editor assigned
On 24 Jan, 2020
Editor invited
On 23 Jan, 2020
Submission checks complete
On 22 Jan, 2020
No comments provided
Reviewer #2 agreed
On 27 Dec, 2019
Review #2 received
Received 27 Dec, 2019
Editorial decision: Major revision
On 27 Dec, 2019
Review #1 received
Received 29 Nov, 2019
Reviewers invited
Invitations sent on 22 Nov, 2019
Reviewer #1 agreed
On 22 Nov, 2019
Editor assigned
On 14 Nov, 2019
Submission checks complete
On 07 Nov, 2019
Editor invited
On 05 Nov, 2019
First submitted
On 02 Nov, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Ophthalmology.
Background: We investigated the effect of pupil dilation on predicted postoperative refraction (PPR) and recommended intraocular lens (IOL) power calculated using three different generations of IOL power calculation formulas: Barrett Universal II (Barrett) (new generation), Haigis (4th generation), and SRK/T (3rd generation). Methods: This retrospective study included 150 eyes. All variables were measured and calculated using a ZEISS IOL Master 700. The following variables were measured before and after dilation: anterior chamber depth (ACD), lens thickness (LT), white-to-white (WTW). PPR and recommended IOL power were calculated by Barrett, Haigis, and SRK/T IOL calculation formulas. The change in each variable before and after dilation, and correlations between all changes were analyzed using the Wilcoxon signed-rank test and the Spearman’s rank-order correlation test, respectively. The influence of pupil dilation on recommended IOL power calculated by each formula was also analyzed. Results: The mean absolute change (MAC) in PPR before and after dilation was highest in Barrett, followed by Haigis and SRK/T. Significant differences were found among each MACs (P < 0.0001). Significant changes were observed before and after dilation in ACD and LT (P < 0.0001) but not in WTW. In Barrett and Haigis, there was a significant positive correlation between change in PPR and change in ACD (P < 0.0001) and a negative correlation between change in PPR and change in LT (P < 0.0001). Correlations were strongest in Barret followed by Haigis, especially in LT. Change in PPR in Barrett also demonstrated a significant positive correlation with change in WTW (P = 0.022). The recommended IOL power using Barrett and Haigis changed before and after dilation in 23.3% and 19.3% cases; SRK/T showed no change. Conclusions: In PPR and recommended IOL power, pupil dilation influenced Barrett most strongly, followed by Haigis and SRK/T. Given the stronger correlation between the change in PPR in Barrett and the change in ACD, LT, and WTW, the change of ACD, LT, and WTW is more important to the influence of dilation on Barrett. The influence of dilation on each formula and variable, including ACD, LT, and WTW, is key to improving IOL calculation.
Figure 1
Figure 2
Figure 3
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