title: Combination of 5% phenylephrine and 0.5% tropicamide eyedrops for pupil dilation in neonates is twice as effective as 0.5% tropicamide eyedrops alone.
abstract: OBJECTIVE
  Comparison of the efficacy of tropicamide eyedrops to the combination of 0.5% tropicamide and 5% phenylephrine eyedrops in order to achieve a proper dilation in premature infants undergoing screening for retinopathy of prematurity.
  
  
  METHODS
  A prospective, randomized, double-blind study was conducted to compare the efficacy of two mydriatic regimens: one regimen consisting of three drops of 0.5% tropicamide (TTT regimen), the other regimen consisting of one drop of 5% phenylephrine and two drops of 0.5% tropicamide (PTT regimen). Thirty premature infants were enrolled and received both mydriatic regimens: one regimen in each eye. Outcomes were pupil dilation evaluated by the percentage of pupil diameter over cornea diameter, the percentage of pupil surface over cornea surface and the quality of the eye fundus examination.
  
  
  RESULTS
  The percentage of pupil diameter over cornea diameter was 47.3% (±8.7) with the TTT regimen and 65.9% (±8.8) with the PTT regimen (p < 0.0001). The percentage of pupil surface over cornea surface was 23.1% (±8.3) with the TTT regimen and 43.8% (±7.3) with the PTT regimen (p < 0.0001). Thus, the pupil surface area was 1.9 times greater with the PTT than with the TTT regimen. Visualization of the retinal periphery was possible for 30 of 30 eyes dilated with the PTT regimen and for 16 of 30 eyes dilated with the TTT regimen (p < 0.0001).
  
  
  CONCLUSIONS
  The dilated pupil surface area for the combination of 5% phenylephrine and 0.5% tropicamide was almost twice that for 0.5% tropicamide eyedrops alone and provided significantly superior quality of the eye fundus examination.
authors: Medical School, Unicaen, PFRS, Caen Cedex, France.|Department of Ophthalmology, Caen University Hospital Center, Caen Cedex, France.
authors: Anne-Laure
authors: AL
authors: Lux
authors: Medical School, Unicaen, PFRS, Caen Cedex, France.|Department of Ophthalmology, Caen University Hospital Center, Caen Cedex, France.
authors: Alice
authors: A
authors: Degoumois
authors: Department of Dr Caputo, Fondation A Rothschild, Paris, France.
authors: Amandine
authors: A
authors: Barjol
authors: Department of Ophthalmology, Rennes University Hospital Center, Rennes, France.|Medical School, University of Rennes 1, Rennes, France.
authors: Frédéric
authors: F
authors: Mouriaux
authors: Medical School, Unicaen, PFRS, Caen Cedex, France.|Department of Ophthalmology, Caen University Hospital Center, Caen Cedex, France.|Inserm, U 1075 COMETE PFRS, Caen Cedex, France.
authors: Eric
authors: E
authors: Denion
mesh_terms: D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage; D015997:Neonatal Screening / Q000379:methods*; D009883:Ophthalmic Solutions; D009887:Ophthalmoscopy; D010656:Phenylephrine / Q000008:administration & dosage*; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*; D015203:Reproducibility of Results; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000503:physiopathology; D013997:Time Factors; D014331:Tropicamide / Q000008:administration & dosage*
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D014331:Tropicamide
keywords: mydriatic regimen; phenylephrine; pupil dilation; retinopathy of prematurity; tropicamide