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Combination cyclopentolate and phenylephrine for mydriasis in premature infants with heavily pigmented irides
Insights
A combination eyedrop of cyclopentolate 0.2% and phenylephrine 1% effectively dilates pupils in premature infants with dark irides. This safe mydriatic regimen is comparable to other agents for retinopathy of prematurity screening.
Area of Science:
- Ophthalmology
- Neonatal Medicine
Background:
- Premature infants often require eye examinations for conditions like retinopathy of prematurity.
- Achieving adequate pupil dilation (mydriasis) in infants with heavily pigmented irides can be challenging.
Purpose of the Study:
- To evaluate the safety and efficacy of a combination cyclopentolate 0.2% and phenylephrine 1% eyedrop for mydriasis in premature infants.
- To compare this combination regimen with a standard tropicamide 0.5% and phenylephrine 2.5% regimen.
Main Methods:
- A prospective, randomized, double-blind study involving 28 premature infants (birthweight <1600 g) with dark irides.
- Infants received both combination cyclopentolate/phenylephrine and tropicamide/phenylephrine regimens twice within a 2-week period.
- Pupil size, blood pressure, and heart rate were monitored.
Main Results:
- Both regimens successfully achieved good mydriasis without significant differences in pupil size.
- No significant differences in blood pressure were observed between the groups.
- Pulse rates showed slight deceleration in both groups, but the changes were not clinically significant.
Conclusions:
- The combination eyedrop of cyclopentolate 0.2% and phenylephrine 1% is a safe and effective mydriatic agent for premature infants with dark irides.
- This single combination eyedrop offers comparable efficacy and safety to the triple instillation of tropicamide 0.5% and phenylephrine 2.5%.
Purpose:
This study examined whether safe and effective mydriasis can be achieved in premature infants with heavily pigmented irides using combination cyclopentolate 0.2% and phenylephrine 1% eyedrops.
Methods:
A prospective, randomized double-blind study was performed to compare combination cyclopentolate 0.2% and phenylephrine 1% eye-drops with triple instillation of tropicamide 0.5% and phenylephrine 2.5%. Twenty-eight consecutive babies with dark irides and birthweight <1600 g referred for screening for retinopathy of prematurity comprised the study population. Infants' eyes were randomly dilated twice with both regimens within a 2-week period. Blood pressure, heart rate, and pupil size were measured.
Results:
Good mydriasis was achieved in both groups with no significant differences in pupil size or blood pressure (systolic, diastolic, or mean arterial pressures) over starting baseline values. Pulse rates decelerated below the baseline values in both groups, but these differences were not large.
Conclusion:
The single combination eyedrop of cyclopentolate 0.2% and phenylephrine 1% is as effective and safe a mydriatic for infants with dark irides as both tropicamide 0.5% and phenylephrine 2.5%.