RESUMEN
Background: In ophthalmology (OPD), cycloplegics or mydriatics were needed for doing correct refraction and evaluation of fundus on a daily basis. Aims and Objectives: The objectives of this study were to compare the clinical efficacy and systemic side effects of different dilutions of phenylephrine and tropicamide combinations drops on pupil dilatation and to measure and compare pulse rate and blood pressure before and after giving the drug. Materials and Methods: The present study is a hospital-based interventional study conducted among patients attending to OPD of Regional Eye hospital, Visakhapatnam during April 2012–August 2012. Eighty-one patients randomly allocated to two groups (41 patients in Group 1 and 40 patients in Group 2). Dilution of phenylephrine 5% and Tropicamide 0.8% mixture was applied to patients of Group A in both eyes and dilution of phenylephrine 2.5% and Tropicamide 0.4% mixture was applied to Group B patients in both eyes. Pupil diameter and pulse rate BP were measured and compared. Results: Mean age of Group 1 patients was 55.39 ± 11.47 and Group 2 was 49.95 ± 13.71. Among 36 males, 50% in Group 1 and 50% in Group 2 and among 45 females 51.1% in Group 1 and 48.9% in Group 2. Among both Group 1 and Group 2 patients, both left and right pupil size was significantly increased after application of dilutions, but there was more increase in the pupil size among Group 1 patients compared to Group 2 patients 15 min after and 30 min after application of drug. Conclusions: The combination of 0.8% tropicamide and 5% phenylephrine was effective compared to alternate application of 0.4% tropicamide and 2.5% phenylephrine for rapid and sustainable pupil dilatation for indirect ophthalmoscopy.
RESUMEN
Purpose: To compare the efficacy in pupil dilatation between a mixture containing 0.75% tropicamide and 2.5% phenylephrine and the alternate application of 1% tropicamide and 10% phenylephrine eye drops. Material and Methods: Patients requiring pupil dilatation were randomized to receive one drop of the mixture every 10 min for four times or our standard application of one drop of 1% tropicamide alternating with one drop of 10% phenylephrine every 10 min for two cycles. Pupil size was measured under bright light with the pupil gauge before, and every 5 min after initial application for 40 min. Application of the drops was discontinued once the pupil diameter reached 7 mm. Blood pressure and pulse rate were monitored every 15 min. Results: Of 40 patients (age 57.3±10.9 years, range 35-70 years), 22 were randomized into the mixture group and 18 into the alternate drug group. Baseline pupil sizes were 1.7±0.5 mm in the mixture group and 1.8±0.4 mm in the alternate drug group. The pupils were successfully dilated to 7 mm within 40 min in 17 patients of the mixture group compared to seven patients in the alternate drug group (P=0.004, Log Rank test). The mean pupil sizes at 40 min were 6.6±0.8 and 6.0±0.9 mm in the mixture and alternate drug groups respectively (P=0.050, t-test). Blood pressure and pulse rate were stable and similar in both groups. Conclusions: The mixture of 0.75% tropicamide and 2.5% phenylephrine is superior to our standard application of 1% tropicamide alternating with 10% phenylephrine. It provides faster and more successful pupil dilatation within 40 min.