Comparative study on the safety and efficacy of different cycloplegic agents in children with darkly pigmented irides.
BACKGROUND
The ideal cycloplegic drug that is safe, effective and convenient in children is not yet available. This study aimed to evaluate the safety and efficacy of three cycloplegic regimens in hyperopic children with pigmented irides. The responses to cycloplegia in different age groups and presence of strabismus were also compared.


METHODS
Tropicamide 0.5% and phenylephrine 0.5% (regimen I), tropicamide 1.0% and cyclopentolate 1.0% (regimen II), and atropine 1.0% (regimen III) were evaluated in 25 children using a crossover study design. Cycloplegic refractions were assessed.


RESULTS
The mean age of the children was 5.7 +/- 2.0 years (range 2.5-10.8 years). Six (24.0%) of them had strabismus. The spherical equivalent (SE) refraction for regimens I, II and III were +5.11 +/- 2.04 D, +5.29 +/- 1.89 D and +5.71 +/- 1.90 D, respectively, and were significant different from the manifest SE (+3.95 +/- 2.17 D) (P < 0.001). There was no statistical difference between regimen I and II in children without strabismus (P = 0.258) or aged older than 5 years (P > 0.050).


CONCLUSIONS
In older children, regimen I was as effective as regimen II and can be used to avoid cyclopentolate toxicity.
Fan
Dorothy S P
DS
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong. dorothyfan@cuhk.edu.hk
Rao
Srinivas K
SK
Ng
Joan S K
JS
Yu
Christopher B O
CB
Lam
Dennis S C
DS
D001285:Atropine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003519:Cyclopentolate / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005127:Eye Color / Q000187:drug effects*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000175:diagnosis; D007498:Iris / Q000187:drug effects*; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D010656:Phenylephrine / Q000008:administration & dosage; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*; D012029:Refraction, Ocular; D012449:Safety; D014331:Tropicamide / Q000008:administration & dosage
D009184:Mydriatics; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D001285:Atropine; D003519:Cyclopentolate; D014331:Tropicamide