Combination cyclopentolate and phenylephrine for mydriasis in premature infants with heavily pigmented irides.
OBJECTIVE
This study examined whether safe and effective mydriasis can be achieved in premature infants with heavily pigmented irides using combination cyclopentolate 0.2% and phenylephrine 1% eyedrops.


METHODS
A prospective, randomized double-blind study was performed to compare combination cyclopentolate 0.2% and phenylephrine 1% eye-drops with triple instillation of tropicamide 0.5% and phenylephrine 2.5%. Twenty-eight consecutive babies with dark irides and birthweight <1600 g referred for screening for retinopathy of prematurity comprised the study population. Infants' eyes were randomly dilated twice with both regimens within a 2-week period. Blood pressure, heart rate, and pupil size were measured.


RESULTS
Good mydriasis was achieved in both groups with no significant differences in pupil size or blood pressure (systolic, diastolic, or mean arterial pressures) over starting baseline values. Pulse rates decelerated below the baseline values in both groups, but these differences were not large.


CONCLUSIONS
The single combination eyedrop of cyclopentolate 0.2% and phenylephrine 1% is as effective and safe a mydriatic for infants with dark irides as both tropicamide 0.5% and phenylephrine 2.5%.
Khoo
B K
BK
Department of Neonatology I, Kandang Kerbau Hospital, Singapore.
Koh
A
A
Cheong
P
P
Ho
N K
NK
D003519:Cyclopentolate / Q000008:administration & dosage / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005127:Eye Color / Q000187:drug effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007498:Iris / Q000187:drug effects / Q000502:physiology; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage / Q000627:therapeutic use*; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D010656:Phenylephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*; D012178:Retinopathy of Prematurity / Q000175:diagnosis; D012449:Safety; D014331:Tropicamide / Q000008:administration & dosage / Q000627:therapeutic use
D009184:Mydriatics; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D003519:Cyclopentolate; D014331:Tropicamide