Efficacy of dapiprazole with hydroxyamphetamine hydrobromide and tropicamide

Clinical interest in ophthalmic agents to reverse pharmacologically induced mydriasis safely has been attempted for over fifty years. These agents may aid practitioners in assisting the younger patient to regain unable near visual function.

We evaluated the usefulness of dapiprazole in a private clinical setting. Our study was doubled masked, randomized and used one eye of each subject as a control. Twenty-six consecutive subjects were given dapiprazole as directed by its manufacturer. This administration of dapiprazole followed bilateral pupil dilation with proparacaine 0.5%, hydroxyamphetamine 1.0% and tropicamide 0.25%. Pupil diameter, amplitude of accommodation, intraocular pressure and conjunctival injection were each evaluated prior to instillation of the diagnostic agents, immediately before the instillation of dapiprazole and at 30, 60, 120, and 180 minutes after the final instillation of dapiprazole.

The average pupillary recovery time for dapiprazole-treated eyes was similar to previously published data. Accommodation also showed significant recovery, with comfortable reading ability returning by approximately 45 minutes.

The design of our study did not permit us to determine what portion of accommodation recovery if any was attributable to a ciliary muscle effect and what portion may have resulted from the increased depth of field attending pupillary constriction.