Using tropicamide and phenylephrine without cyclopentolate for pupil dilation in cataract surgery reduces postoperative intraocular pressure rise

  • Rachel Xuan Royal North Shore Hospital
  • Keith Ong Department of Ophthalmology, Royal North Shore Hospital, Sydney, Australia Northern Clinical School, University of Sydney, Sydney, Australia Chatswood Private Hospital, Sydney, Australia Sydney Adventist Hospital, Sydney, Australia Save Sight Institute, University of Sydney, Sydney, Australia
Keywords: cataract, cyclopentolate, intraocular pressure, pupil dilatation

Abstract

The aim of this retrospective study was to evaluate whether intraocular (IOP) elevation post-cataract surgery can be reduced by using tropicamide and phenylephrine only, without cyclopentolate. Medical records across two surgical facilities were analyzed. One surgical facility (Cohort A) used a combination of tropicamide, cyclopentolate, and phenylephrine preoperatively, while the other (Cohort B) used tropicamide and phenylephrine only. Of patients in Cohort A, 63.6% (n = 7) had a higher IOP in the operated eye, while it was only 27.3% (n = 3) in Cohort B. Therefore, it is preferable to exclude the use of cyclopentolate in the preoperative dilation regimen of patients undergoing cataract surgery. However, a study with a larger sample population is required to further evaluate the significance of these results.

References

Zanetti F, Fulco EA, Chaves FR, da Costa Pinto A, Arieta CE, Lira RP. Effect of preoperative use of topical prednisolone acetate, ketorolac tromethamine, nepafenac and placebo, on the maintenance of intraoperative mydriasis during cataract surgery: A randomized trial. Indian J Ophthalmol. 2012;60(4):277-281.

Hancox J, Murdoch I, Parmar D. Changes in intraocular pressure following diagnostic mydriasis with cyclopentolate 1%. Eye (London, England). 2002;16(5):562-566.

Li G, Farsiu S, Chiu SJ, et al. Pilocarpine-induced dilation of Schlemm’s canal and prevention of lumen collapse at elevated intraocular pressures in living mice visualized by OCT. Invest Ophthalmol Vis Sci. 2014;55(6):3737-3746.

Lahdes K, Huupponen R, Kaila T, Monti D, Saettone MF, Salminen L. Plasma concentrations and ocular effects of cyclopentolate after ocular application of three formulations. Br J Clin Pharmacol. 1993;35(5):479-483.

Sani RY, Hassan S, Habib SG, Ifeanyichukwu EP. Cycloplegic effect of atropine compared with cyclopentolate-tropicamide combination in children with hypermetropia. Niger Med J. 2016;57(3):173-177.

Stanley RG. Ocular clinical pharmacology. In: Maddison JE, Page SW, Church DB, editors. Small Animal Clinical Pharmacology (2nd Edition). Edinburgh: WB Saunders; 2008. p. 557-573.

Kilic O, Ozturk M, Ata Gozcelioglu E. Tropicamide ophthalmic solution reduces clozapine-induced sialorrhea: a case report. Psychiat Clin Psych. 2017;27(4):431-434.

Published
2020-12-31
How to Cite
Xuan, R., & Ong, K. (2020). Using tropicamide and phenylephrine without cyclopentolate for pupil dilation in cataract surgery reduces postoperative intraocular pressure rise. Asian Journal of Ophthalmology, 17(3), 285-289. https://doi.org/10.35119/asjoo.v17i3.845