Advantageous effect of pupil dilation on the quality of optical biometry axial length measurement in individuals with dense cataract.

Abstract

To evaluate the effect of pharmacologic pupil dilation on the quality of axial length (AL) measurement in patients with dense cataracts and previous low-quality AL measurements performed without dilation. Shaare-Zedek Medical Center, Jerusalem, Israel. Retrospective case series. All participants underwent swept-source optical coherence tomographic (SS-OCT) biometry. Those with low-quality AL measurements due to dense cataract underwent an additional SS-OCT biometric evaluation after pupil dilation, and the AL measurement of the same eye was recorded. 2076 patients underwent SS-OCT during the study period, and 177 (8.52%) had low-quality AL measurements because of dense cataract. 79 (44.63%, mean age 72.53 ± 13.27 years, 43 females) of those 177 patients underwent repeat SS-OCT biometric imaging after pharmacologic pupil dilation, and formed the study group. After pupil dilation, high-quality AL measurements were successfully obtained in 60 (75.95%) of the 79 eyes. The mean SD of the AL measurements decreased significantly ( P < .001), and the number of successful OCT scans per measurement increased significantly ( P < .001) after pupil dilation. The mean difference of the AL before and after pupil dilation was 0.03 ± 0.07 mm ( P < .001). Pharmacologic pupil dilation improved the quality of SS-OCT biometrically measured AL in patients with low-quality AL measurement due to dense cataract. These results could potentially improve postoperative refractive outcomes after cataract surgery and reduce the need of additional AL measurements by more complicated alternative means in this group.