Acute effects of topical phenylephrine on aqueous humor dynamics and corneal endothelial permeability in man

Acute effects of topical phenylephrine, an alpha-1 adrenergic agonist, on the aqueous humor dynamics and corneal endothelial permeability were studied by means of the oral fluorescein method in 11 normal young volunteers. Twenty microliters of phenylephrine HCL (10%) was instilled in one eye and the placebo in the other eye in a double masked manner. The instillations were carried out 0.5 hour before, and 2, 4 and 6 hours after the fluorescein ingestion. Fluorophotometric measurements were carried out in the central cornea, anterior chamber and plasma ultrafiltrate, and the aqueous-cornea transfer coefficient in reference to the corneal volume (kc.ac), the transfer coefficient in the anterior chamber by diffusion (kd.pa) and by flow (kfa) were calculated in each eye. The thickness of the cornea (CT), intraocular pressure (IOP) and anterior chamber volume (Va) were also measured. No significant difference was found in the CT, kc.ac, corneal endothelial permeability (kc.ac x the thickness of the stroma), Va, IOP and kfa between the experimental and control eyes, while the kd.pa was significantly smaller in the experimental eyes (paired t-test, P less than 0.01). The iris permeability factor (kd.pa x Va) decreased significantly to 0.74 +/- 0.26 (Mean +/- SD) of the control (P less than 0.01). The aqueous flow rate (kfa x Va) averaged 0.95 +/- 0.21 of the control, and the difference from unity was not significant (P greater than 0.1).