ABSTRACT
Background: The use of mydriatic and cycloplegic eye drops is a common practice in ophthalmology for various diagnostic and therapeutic procedures like for estimation of refractive error and for thorough fundus examination. The combination of Tropicamide and Phenylephrine has been a subject of debate among ophthalmologists regarding its efficacy and side effects. Aims and Objectives: The aim of this study was to evaluate the efficacy and safety of 1% Tropicamide alone versus a combination of 0.8% Tropicamide and 5% Phenylephrine for mydriasis and cycloplegia. The objectives were to compare the rate of mydriasis and maximal mydriasis after instilling a single drop of each solution and to measure the degree of cycloplegia and amount of residual accommodation at 25 minutes after instillation of the drops. Method(s): This was a hospital-based, analytic cross-sectional study conducted on 100 patients between 15 and 35 years of age presenting to the Department of Ophthalmology, Government Medical College and Associated Group of Hospitals, Kota for refraction or fundus examination. Patients were randomly assigned to either the Tropicamide group or the Tropicamide-Phenylephrine group. The study measured the rate of mydriasis, maximal mydriasis after eye drop instillation. Study also measured the degree of cycloplegia and amount of residual accommodation at 25 minutes after instillation of the drop. Result(s): The combination of Tropicamide and Phenylephrine resulted in a higher rate of mydriasis and maximal mydriasis than Tropicamide alone. Tropicamide alone uncovered significantly higher mean latent error of refraction and had higher cycloplegic effect as compared to combination group. The study also found that increasing age lead to increased cycloplegia and decreased residual accommodation in both groups. It was also found that both groups had a similar safety profile, with no significant adverse effects observed except significant increase in pulse rate after instillation of combination eye drop. Conclusion(s): The combination of Tropicamide and Phenylephrine is more effective than Tropicamide alone for inducing mydriasis with a similar safety profile except significant change in pulse rate. While Tropicamide alone had better cycloplegic effect.Copyright © 2023, Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.
ABSTRACT
Purpose: To report the design and baseline data of a 3-year cohort study in Beijing Pinggu District primary school students in China after COVID-19. Methods: Noncycloplegic and cycloplegic spherical equivalent refraction (SER) were measured, ocular biometry, including the axial length (AL), anterior chamber depth (ACD) and corneal power (CP), were collected before cycloplegia. Corneal radius (CR), AL-to-CR ratio, and lens power (LP) were calculated. Results: Among the 4,806 (89.1%) eligible students (51.5% male), the prevalence of emmetropia, myopia, mild hyperopia, and mild-to-high hyperopia was 12.8, 30.8, 53.0, and 3.3% after cycloplegia, respectively. Myopia increased from 2.5% in 6- to 71.6% in 12-year-old students, with 9- and 10-year-olds showing the most prominent increases. The median of cycloplegic SER was 0.50 (IQR = 1.63), and the noncycloplegic SER was -0.38 D (IQR = 1.50), which is more negative than the cycloplegic refraction. The mean AL increased with age, from 22.46 ± 0.70 mm to 24.26 ± 1.07 mm. The ACD increased from 3.38 ± 0.28 mm to 3.70 ± 0.30 mm, and the AL-to-CR ratio increased from 2.91 ± 0.08 to 3.12 ± 0.13 between 6- and 12-year-old students. AL, CR and LP explained the SER variance with R2 of 86.4% after adjusting the age and gender. Conclusions and Relevance: The myopia prevalence since emergence of COVID-19 rapidly increased from 6- to 12-year primary school Chinese children, especially after 7 years of age. The non-cycloplegia SER overestimated the prevalence of myopia, and the cycloplegic SER is a more accurate and reliable method to assess the prevalence of refractive status.