Impact Of Pharmacological Mydriasis On Morpho-Biomechanical Profiling And Diagnostic Stability In Keratoconus Via Combined Static And Dynamic Scheimpflug Imaging
Published 2026 - 44th Congress of the ESCRS
Reference: PP14.13 | Type: Free paper | DOI: 10.82333/12r7-2911
Authors: Dr Jinhai Huang* 1 , Dr Jinjin Yu 2 , Dr Xiaomin Huang 1 , Dr Rui Ning 3 , A/Prof. Xingtao Zhou 1
1Eye & ENT Hospital, Fudan University,Shanghai,China, 2Ningbo No. 2 Hospital ,Zhejiang,China, 3Refractive center, the Affiliated Hospital of Yunnan University,Kunming,China
Purpose
As a progressive corneal ectatic disease, the early precision diagnosis and monitoring of keratoconus (KC) rely heavily on corneal topography and biomechanical assessments. Changes in pupil status may influence the accuracy of these parameters. This study aimed to systematically evaluate the impact of 0.5% tropicamide-induced mydriasis on the corneal morphological and biomechanical characteristics of KC patients, providing evidence-based support for clinical decision-making.
Setting
Eye & ENT Hospital of Fudan University, Shanghai, China.
Methods
This prospective study enrolled 83 eyes of 83 KC patients. Following mydriasis induced by 0.5% tropicamide (three 10-min intervals) , Pentacam and Corvis ST assessments were repeated after 30 minutes. Evaluated metrics included morphological (curvature, elevation, pachymetry, BAD-D) and biomechanical indices (DCR parameters, CBI, TBI). Data were analyzed using paired t-tests and visualized via violin plots.
Results
Following mydriasis, Pentacam analysis revealed significant decreases in Front Km, Kmax, Back Km, index of surface variance (ISV), KI, CKI, and BAD-D (P < 0.05). Conversely, central corneal thickness (CCT), apex corneal thickness (ACT), thinnest corneal thickness (TCT), and minimum sagittal curvature showed significant increases. Corvis ST biomechanical analysis demonstrated significant reductions in A2 time, highest concavity deformation amplitude (HCDA), and the CBI (P < 0.05). While these shifts were statistically significant, they did not alter the diagnostic classification of KC.
Conclusions
Pharmacological mydriasis significantly alters corneal topographic and biomechanical parameters in KC patients. Clinicians should remain cognizant of the systematic impact of pupil dilation on quantitative corneal metrics to ensure the accuracy of disease assessment and the reliability of therapeutic decision-making.