Aceclidine, brimonidine tartrate, and dapiprazole: comparison of miotic effect and tolerability under different lighting conditions.
OBJECTIVE
To evaluate the effect of 3 types of topically applied miotic eyedrops on the pupil diameter in normal eyes.


METHODS
Department of Neurosciences, Section of Ophthalmology, University of Pisa, Pisa, Italy.


METHODS
This prospective study comprised 60 eyes of 30 healthy volunteers treated with aceclidine 0.02%, brimonidine tartrate 0.20%, and dapiprazole 0.25%. Pupil diameter was measured under scotopic, mesopic (4 lux), and photopic (50 lux) conditions using an infrared pupillometer incorporated into a CSO topographer. The first measurement was obtained before single instillation of 1 type of miotic eyedrop. Subsequent measurements were taken after 30, 120, and 240 minutes. Each additional medication was tested after an interval of at least 6 weeks to avoid possible effects from the previously administered drug. All patients received a questionnaire and were asked to grade the tolerability of each eyedrop using a subjective scoring system.


RESULTS
Aceclidine 0.02% had no significant miotic effect. Brimonidine tartrate 0.20% caused significant miosis within 30 minutes and 120 minutes; after 240 minutes, the effect under all luminance conditions decreased to baseline levels without reaching the initial level. Dapiprazole 0.25% had a miotic effect similar to that of brimonidine but produced many side effects including hyperemia and burning, which many patients said caused significant discomfort.


CONCLUSIONS
Brimonidine tartrate 0.20% had the best miotic effect of the 3 agents tested and was well tolerated by the patients. The reproducible miotic effect of brimonidine tartrate under all lighting conditions might benefit postoperative refractive patients who report night-vision difficulties related to large pupils.
Canovetti
Annalisa
A
Department of Neurosciences, Section of Ophthalmology, University of Pisa, Pisa, Italy.
Nardi
Marco
M
Figus
Michele
M
Fogagnolo
Paolo
P
Benelli
Umberto
U
D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000494:pharmacology; D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000494:pharmacology; D000328:Adult; D000068438:Brimonidine Tartrate; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D010276:Parasympatholytics / Q000009:adverse effects / Q000819:agonists; D010879:Piperazines / Q000009:adverse effects / Q000494:pharmacology*; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects* / Q000528:radiation effects; D011810:Quinoxalines / Q000009:adverse effects / Q000494:pharmacology*; D011812:Quinuclidines / Q000009:adverse effects / Q000494:pharmacology*; D011795:Surveys and Questionnaires; D014230:Triazoles / Q000009:adverse effects / Q000494:pharmacology*
D000316:Adrenergic alpha-Agonists; D000317:Adrenergic alpha-Antagonists; D010276:Parasympatholytics; D010879:Piperazines; D011810:Quinoxalines; D011812:Quinuclidines; D014230:Triazoles; C084650:aceclidine; D000068438:Brimonidine Tartrate; C035289:dapiprazole