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Randomized clinical trial of the efficacy and safety of tropicamide and phenylephrine in preoperative mydriasis for phacoemulsification

Authors

  • Philip TH Lam FRCOphth,

    1. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, and Hospital Authority Ophthalmic Service, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China
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  • Betty TM Poon FRCS(Ed),

    1. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, and Hospital Authority Ophthalmic Service, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China
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  • Wai-Kwan Wu FRCS(Ed),

    1. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, and Hospital Authority Ophthalmic Service, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China
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  • Stanley CC Chi FRCOphth,

    1. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, and Hospital Authority Ophthalmic Service, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China
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  • Dennis SC Lam FRCOphth

    1. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, and Hospital Authority Ophthalmic Service, Hong Kong Eye Hospital, Kowloon, Hong Kong, People's Republic of China
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  • Presented in part as a poster at the American Society of Cataract and Refractive Surgeons (ASCRS) Symposium in Philadelphia, PA, USA, 1−5 June 2002.

Dr Philip TH Lam, Adjunct Associate Professor, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong. Email: lamth@ha.org.hk

Abstract

Purpose: To compare the mydriatic effect and safety between different concentrations of tropicamide and phenyle­phrine in preoperative mydriasis for phaco­emulsification.

Methods: Two hundred and seventeen consecutive eyes in the same number of Chinese patients undergoing phaco­emulsification under local or topical anaesthesia in a university-based eye hospital were analyzed. Patients were randomized into two groups by cluster randomization, each group receiving a different preoperative mydriatic regimen. Regimen A consisted of tropicamide 1.0% with phenylephrine 2.5%, and Regimen B consisted of tropicamide 0.5% with phenylephrine 0.5%. The main outcome measures were horizontal pupillary diameter, systolic, diastolic and pulse pressure and pulse rate.

Results: The group who received Regimen A attained a mean horizontal pupillary diameter of 7.00 ± 1.06 mm. Their pupils were significantly larger than those receiving Regimen B (6.61 ± 1.03 mm, P = 0.007). No untoward cardiovascular effects were noted in either groups.

Conclusion: Regimen A attained better preoperative mydriasis for phacoemulsification than Regimen B. Both regimens were safe with regard to their cardiovascular effects. The combination of tropicamide 1.0% and phenylephrine 2.5% is recommended as preoperative mydriatic for phacoemulsification in Chinese patients who have darkly pigmented irides.

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