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Influence of the Body Position to Cyclorotation in Healthy Probands
1Gordes R.-S., 1Vaseghi S., 2Pansell T., 2Ygge J., 3Schworm H. D.,
1Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde (Hamburg)
2Karolinska Institut, Universitäts-Augenklinik (Stockholm)
3Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde, Bereich Orthoptik und Pleoptik (Hamburg)
Background: The use of wavefront analysis to improve accuracy in refractive laser surgery raises the question whether the change of body position from erect (position during investigation) to supine (position during treatment) induces ocular cycloduction which necessitates adaptation of the astigmatic axis.
Methods: In 30 healthy probands cycloduction of both eyes was investigated in erect and supine body position and during change of body-position. Mearsurements were performed using the infrared video-oculography technique (3D-VOG", SMI, Teltow, Germany). Prerequisite for inclusion into the study were an uncorrected visual acuity of 6/12 or better, full stereopsis and a regular orthoptic status.
Results: Four different patterns of reaction concerning the induction of cycloduction were detected. One group (n = 10) showed a small amount of cycloduction up to 5°, remaining unchanged during a period of 30 seconds in supine position. A second group (n = 5) revealed a gross cycloduction of up to 20° after change from erect to supine position. In a third group (n = 3) an initial cycloduction induced by the change of body position was followed by a re-orientation of cycloposition to the situation during erect position. A forth group (n = 12) did not show any clinically significant change of cycloduction between erect and supine position. Concerning the four different patterns of reaction no correlation with features such as refraction, age or gender were observed.
Conclusions: The present study demonstrates that a considerable amount of cycloduction can be induced by the change of body position from erect to supine or vice versa. In order to avoid unexpected malcorrections, this phenomen should be taken into account when applying refractive laser sugery, espescially in patients with correction of astigmatism.