TY - JOUR
T1 - Tropicamide has limited clinical effect on cycloplegia and mydriasis when combined with cyclopentolate and phenylephrine
AU - Sherman, Alain E.
AU - Shaw, Melissa M.
AU - Ralay-Ranaivo, Hantamalala
AU - Rahmani, Bahram
N1 - Funding Information:
We acknowledge the Northwestern University Clinical and Translational Sciences Institute (NUCATS) for providing access to REDCap. NUCATS is funded in part by a Clinical and Translational Science Award (CTSA) grant from the National Institutes of Health (NIH) UL1TR001422. We also thank Karen Rychlik and Joshua Korsen for their assistance with data analysis and presentation.
Funding Information:
We acknowledge the Northwestern University Clinical and Translational Sciences Institute (NUCATS) for providing access to REDCap. NUCATS is funded in part by a Clinical and Translational Science Award (CTSA) grant from the National Institutes of Health (NIH) UL1TR001422 . We also thank Karen Rychlik and Joshua Korsen for their assistance with data analysis and presentation.
Publisher Copyright:
© 2019 American Association for Pediatric Ophthalmology and Strabismus
PY - 2019/2
Y1 - 2019/2
N2 - Purpose: To examine the cycloplegic and mydriatic effect of tropicamide omission from a common pediatric eye drop combination. Methods: Consecutive children examined at the Ann & Robert H. Lurie Children's Hospital of Chicago from June 8, 2017 to September 6, 2017 were enrolled prospectively. Tropicamide, cyclopentolate, and phenylephrine (TCP) was instilled in one eye; cyclopentolate and phenylephrine (CP), in the other. Spherical equivalent, maximum pupil size, and pupillary constriction in response to photostimulation were measured before and 30 minutes after instillation using an autorefractor and pupillometer. Iris pigmentation was examined as a between-subjects variable. Results: A total of 75 children 4-11 years of age were included. Mean differences in spherical equivalent between TCP and CP were not statistically significant (P = 0.95). Significant interactions between eye drop regimen and iris pigmentation were observed for pupil size (P = 0.001) and constriction percentage (P = 0.02). Among only patients with dark irides, TCP yielded slightly larger pupils (7.70 vs 7.31 mm [P < 0.001]) that were less responsive to light (5.75% vs 8.07% [P = 0.002]). All pupils dilated to ≥6.0 mm, with equivalent proportions achieving ≥7.0 mm for TCP and CP (P = 0.18). Conclusions: TCP and CP elicited equivalent cycloplegic effects. Mydriatic differences between the regimens, although statistically significant in dark irides, were of limited clinical magnitude, and all pupils achieved sufficient dilation for funduscopy.
AB - Purpose: To examine the cycloplegic and mydriatic effect of tropicamide omission from a common pediatric eye drop combination. Methods: Consecutive children examined at the Ann & Robert H. Lurie Children's Hospital of Chicago from June 8, 2017 to September 6, 2017 were enrolled prospectively. Tropicamide, cyclopentolate, and phenylephrine (TCP) was instilled in one eye; cyclopentolate and phenylephrine (CP), in the other. Spherical equivalent, maximum pupil size, and pupillary constriction in response to photostimulation were measured before and 30 minutes after instillation using an autorefractor and pupillometer. Iris pigmentation was examined as a between-subjects variable. Results: A total of 75 children 4-11 years of age were included. Mean differences in spherical equivalent between TCP and CP were not statistically significant (P = 0.95). Significant interactions between eye drop regimen and iris pigmentation were observed for pupil size (P = 0.001) and constriction percentage (P = 0.02). Among only patients with dark irides, TCP yielded slightly larger pupils (7.70 vs 7.31 mm [P < 0.001]) that were less responsive to light (5.75% vs 8.07% [P = 0.002]). All pupils dilated to ≥6.0 mm, with equivalent proportions achieving ≥7.0 mm for TCP and CP (P = 0.18). Conclusions: TCP and CP elicited equivalent cycloplegic effects. Mydriatic differences between the regimens, although statistically significant in dark irides, were of limited clinical magnitude, and all pupils achieved sufficient dilation for funduscopy.
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U2 - 10.1016/j.jaapos.2018.08.012
DO - 10.1016/j.jaapos.2018.08.012
M3 - Article
C2 - 30641136
AN - SCOPUS:85060891671
SN - 1091-8531
VL - 23
SP - 30.e1-30.e5
JO - Journal of AAPOS
JF - Journal of AAPOS
IS - 1
ER -