title: Effect of Low-Concentration, Nonmydriatic Selective Alpha-Adrenergic Agonist Eyedrops on Upper Eyelid Position.
abstract: BACKGROUND
  Ptosis after botulinum toxin injection is a disturbing complication. Decongestant and antiglaucoma eyedrops are frequently prescribed for temporary improvement of eyelid ptosis. Although frequently cited on informal communications, the effect of these drugs on eyelid position has never been compared in a formal study.
  
  
  OBJECTIVE
  To measure the effect of low-concentration, nonmydriatic selective alpha agonist eyedrops on upper eyelid position.
  
  
  METHODS
  This nonrandomized clinical trial enrolled 20 healthy subjects aged 18 to 50 years. The upper margin-reflex distance (MRD1) was measured before, 30, 60, and 120 minutes after administration of 1 drop of brimonidine 0.2%, phenylephrine 0.12%, or naphazoline 0.05% to the left eye.
  
  
  RESULTS
  There was no statistically significant difference in mean MRD1 between the brimonidine and phenylephrine groups when comparing baseline to all other study time points. After administration of naphazoline 0.05%, MRD1 had a mean increase of 0.56 ± 0.11 mm (p < 0.001) after 30 minutes, 0.47 ± 0.12 mm (p = 0.001) after 60 minutes, and 0.26 ± 0.09 mm (p = 0.028) after 120 minutes when compared with baseline.
  
  
  CONCLUSIONS
  Brimonidine 0.2% and phenylephrine 0.12% have no effect on eyelid aperture, but naphazoline 0.05% eyedrops could be useful for temporary relief of upper eyelid ptosis in selected patients.
authors.affiliation: *Serviço de Oftalmologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; †Departamento de Oftalmologia e Otorrinolaringologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Taís B
authors.initials: TB
authors.lastname: Mendonça
authors.forename: Atauíne P
authors.initials: AP
authors.lastname: Lummertz
authors.forename: Francisco J L
authors.initials: FJ
authors.lastname: Bocaccio
authors.forename: Fernando
authors.initials: F
authors.lastname: Procianoy
mesh_terms: D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage*; D000328:Adult; D001763:Blepharoptosis / Q000139:chemically induced / Q000188:drug therapy; D001905:Botulinum Toxins / Q000009:adverse effects; D000068438:Brimonidine Tartrate / Q000008:administration & dosage; D005143:Eyelids / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D009278:Naphazoline / Q000008:administration & dosage; D009883:Ophthalmic Solutions; D010656:Phenylephrine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000316:Adrenergic alpha-Agonists; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D000068438:Brimonidine Tartrate; D001905:Botulinum Toxins; D009278:Naphazoline