Randomized clinical trial of the efficacy and safety of tropicamide and phenylephrine in preoperative mydriasis for phacoemulsification.
OBJECTIVE
To compare the mydriatic effect and safety between different concentrations of tropicamide and phenyle-phrine in preoperative mydriasis for phaco-emulsification.


METHODS
Two hundred and seventeen consecutive eyes in the same number of Chinese patients undergoing phaco-emulsification under local or topical anaesthesia in a university-based eye hospital were analyzed. Patients were randomized into two groups by cluster randomization, each group receiving a different preoperative mydriatic regimen. Regimen A consisted of tropicamide 1.0% with phenylephrine 2.5%, and Regimen B consisted of tropicamide 0.5% with phenylephrine 0.5%. The main outcome measures were horizontal pupillary diameter, systolic, diastolic and pulse pressure and pulse rate.


RESULTS
The group who received Regimen A attained a mean horizontal pupillary diameter of 7.00 +/- 1.06 mm. Their pupils were significantly larger than those receiving Regimen B (6.61 +/- 1.03 mm, P = 0.007). No untoward cardiovascular effects were noted in either groups.


CONCLUSIONS
Regimen A attained better preoperative mydriasis for phacoemulsification than Regimen B. Both regimens were safe with regard to their cardiovascular effects. The combination of tropicamide 1.0% and phenylephrine 2.5% is recommended as preoperative mydriatic for phacoemulsification in Chinese patients who have darkly pigmented irides.
Lam
Philip T H
PT
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, People's Republic of China. lamth@ha.org.hk
Poon
Betty T M
BT
Wu
Wai-Kwan
WK
Chi
Stanley C C
SC
Lam
Dennis S C
DS
D000368:Aged; D000772:Anesthesia, Local / Q000379:methods; D001794:Blood Pressure / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage / Q000627:therapeutic use*; D018918:Phacoemulsification; D010656:Phenylephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D011300:Preoperative Care; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*; D012449:Safety; D014331:Tropicamide / Q000008:administration & dosage / Q000627:therapeutic use*
D009184:Mydriatics; D010656:Phenylephrine; D014331:Tropicamide