Influence of cycloplegia with topical cyclopentolate on higher-order aberrations in myopic children

Purpose To investigate the influence of cycloplegia with topical cyclopentolate on wavefront aberrations in myopic children. Design This is a prospective, comparative study. Methods Twenty-eight myopic children with a mean age of 7.25+/-2.55 were enrolled in this study. We evaluated refraction and wavefront aberrations before and after cycloplegia with 1% cyclopentolate hydrochloride. Ocular and corneal aberrations were simultaneously measured and compared with each other. Individual Zernike components were also analyzed up to the sixth order. All these parameters were compared before and after cycloplegia. Results Ocular higher-order aberrations (HOAs) significantly increased after cycloplegia (P = 0.012 for spherical-like and P = 0.015 for total HOAs). Corneal HOAs did not change after cycloplegia. When corneal and ocular HOAs were compared, the ocular HOAs were significantly smaller than the corneal HOAs in spherical-like aberrations (P<0.001) and total HOAs (P = 0.006). As for individual Zernike components, ocular aberration generally showed smaller or equivalent values in comparison with corneal aberration. In addition, each Zernike component showed a large standard deviation. Conclusions Internal optics compensates for corneal HOAs in myopic children, and paralysis of tonic accommodation with cyclopentolate considerably affects ocular HOAs. However, inter-individual variation in each Zernike component is quite large in myopic children.