Japanese Journal of Ophthalmology

, Volume 51, Issue 2, pp 111–115 | Cite as

Cycloplegic Effect of 0.5%Tropicamide and 0.5%Phenylephrine Mixed Eye Drops: Objective Assessment in Japanese Schoolchildren with Myopia

  • Ichiro Hamasaki
  • Satoshi Hasebe
  • Shuhei Kimura
  • Manabu Miyata
  • Hiroshi Ohtsuki
CLINICAL INVESTIGATION

Abstract

Purpose

To evaluate the cycloplegic effect of mixed eye drops containing 0.5% tropicamide and 0.5% phenylephrine in myopic children, and to determine whether their efficacy was associated with their clinical characteristics.

Methods

Eighty-one myopic children (age, mean ± SD, 11.0 ± 1.5 years; mean spherical equivalent refractive error, −4.27 ± 1.41 D; range, −1.57 to −8.66 D) were recruited. One drop of Mydrin-P was administered to each eye twice, with an interval of 5 min between. Twenty-five minutes after the second drop, accommodative responses were measured with an open-view autorefractometer, while the subject was encouraged to accommodate by binocularly looking at a Maltese cross located at a distance of 33 cm. The difference between the refractive reading and that obtained with a Maltese cross at 500 cm was regarded as residual accommodation (RA). The repeatability of this measurement was also evaluated.

Results

The mean RA was 0.21 ± 0.29 D (range, −0.31 to 0.99 D). There was no association in RA between the right and left eyes, between RA and age, or between RA and sex, but RA was weakly correlated with refractive error (r = 0.274, P = 0.019). The intersubject difference found in RA can be explained mostly by the extent of repeatability (±0.71 D).

Conclusion

The insignificant magnitude of RA indicated that the mixed eye drop is an acceptable and useful cycloplegic agent in Japanese schoolchildren with a wide range of myopic refractive errors. Jpn J Ophthalmol 2007;51:111–115 © Japanese Ophthalmological Society 2007

Key words

autorefractometer cyclopegic effect residual accommodation myopia children 

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References

  1. 1.
    Zadnik, K, Mutti, DO, Adams, AJ 1992The repeatability of measurement of the ocular componentsInvest Ophthalmol Vis Sci3323252333PubMedGoogle Scholar
  2. 2.
    Gettes, BC 1961Tropicamide, a new cycloplegic mydriaticArch Ophthalmol65632635PubMedGoogle Scholar
  3. 3.
    Gettes, BC, Belmont, O 1961Tropicamide: comparative cycloplegic effectsArch Ophthalmol66336340PubMedGoogle Scholar
  4. 4.
    Applebaum, M, Jaanus, SD 1983Use of diagnostic pharmaceutical agents and incidence of adverse effectsAm J Optom Physiol Opt60384388PubMedGoogle Scholar
  5. 5.
    Milder, B 1961Tropicamide as a cycloplegic agentArch Ophthalmol667072PubMedGoogle Scholar
  6. 6.
    Lovasik, JV 1986Pharmacokinetics of topically applied cyclopentolate HCl and tropicamideAm J Optom Physiol Opt63787803PubMedGoogle Scholar
  7. 7.
    Egashira, SM, Kish, LL, Twelker, JD,  et al. 1993Comparison of cyclopentolate vs. tropicamide cycloplegia in childrenOptom Vis Sci7010191026PubMedCrossRefGoogle Scholar
  8. 8.
    Mutti, DO, Zadnik, K, Egashira, S,  et al. 1994The effect of cycloplegia on measurement of the ocular componentsInvest Ophthalmol Vis Sci35515527PubMedGoogle Scholar
  9. 9.
    Lin, LL, Shih, YF, Hsiao, CH,  et al. 1998The cycloplegic effects of cyclopentolate and tropicamide on myopic childrenJ Ocul Pharmacol Ther14331335PubMedGoogle Scholar
  10. 10.
    Manny, RE, Hussein, M, Scheiman, M,  et al. 2001Tropicamide (1%): an effective cycloplegic agent for myopic childrenInvest Ophthalmol Vis Sci4217281735PubMedGoogle Scholar
  11. 11.
    Gwiazda, J, Hyman, L, Hussein, M,  et al. 2003A randomized clinical trial of progressive addition lenses versus single vision lenses on the progression of myopia in childrenInvest Ophthalmol Vis Sci4414921500PubMedCrossRefGoogle Scholar
  12. 12.
    Kleinstein, RN, Jones, LA, Hullett, S,  et al. 2003Refractive error and ethnicity in childrenArch Ophthalmol12111411147PubMedCrossRefGoogle Scholar
  13. 13.
    Hasebe, S, Nonaka, F, Nakatsuka, C,  et al. 2005Myopia control trial with progressive addition lenses in Japanese schoolchildren: baseline measures refraction, accommodation, heterophoriaJpn J Ophthalmol492330PubMedCrossRefGoogle Scholar
  14. 14.
    Varughese, S, Varughese, RM, Gupta, N,  et al. 2005Refractive error at birth and its relation to gestational ageCurr Eye Res30412428CrossRefGoogle Scholar
  15. 15.
    Phillips, JR 2005Monovision slows juvenile myopia progression unilaterallyBr J Ophthalmol8911961200PubMedCrossRefGoogle Scholar
  16. 16.
    Nakatsuka, C, Hasebe, S, Nonaka, F, Ohtsuki, H 2005Accommodative lag under habitual seeing conditions: comparison between myopic and emmetropic childrenJpn J Ophthalmol49189194PubMedCrossRefGoogle Scholar
  17. 17.
    Blant, JM, Altman, DG 1986Statistical methods for assessing agreement between two methods of clinical measurementLancet1307310Google Scholar
  18. 18.
    Cornbleet, PJ, Gochman, N 1979Incorrect least-squares regression coefficients in method-comparison analysisClin Chem25432438PubMedGoogle Scholar
  19. 19.
    Green, DG, Powers, MK, Banks, MS 1980Depth of focus, eye size and visual acuityVision Res20827835PubMedCrossRefGoogle Scholar
  20. 20.
    Tuan, KA, Somani, S, Chernyak, DA 2005Changes in wavefront aberration with pharmaceutical dilating agentsJ Refract Surg5S530534Google Scholar
  21. 21.
    Oshika, T, Mimura, T, Tanaka, S,  et al. 2002Apparent accommodation and corneal wavefront aberration in pseudophakic eyesInvest Ophthalmol Vis Sci4328822886PubMedGoogle Scholar
  22. 22.
    Lovasik, JV, Kergoat, H 1990Time course of cycloplegia induced by a new phenylephrine–tropicamide combination drugOptom Vis Sci67352358PubMedCrossRefGoogle Scholar
  23. 23.
    Zetterstrom, C 1985A cross-over study of the cycloplegic effects of a single topical application of cyclopentolate–phenylephrine and routine atropinization for 3.5 daysActa Ophthalmol (Copenh)63525529Google Scholar
  24. 24.
    Alimgil, ML, Erda, N 1992The cycloplegic effect of atropine in comparison with the cyclopentolate–tropicamide–phenylephrine combinationKlin Monatsbl Augenheilkd201911PubMedCrossRefGoogle Scholar
  25. 25.
    Culhane, HM, Winn, B, Gilmartin, B 1999Human dynamic closed-loop accommodation augmented by sympathetic inhibitionInvest Ophthalmol Vis Sci4011371143PubMedGoogle Scholar
  26. 26.
    Ostrin, LA, Glasser, A 2004The effect of phenylephrine on pupil diameter and accommodation in Rhesus monkeysInvest Ophthalmol Vis Sci45215221PubMedCrossRefGoogle Scholar
  27. 27.
    Mine, K, Hirai, H, Uozato, H,  et al. 1985A comparative study of tropicamide and cyclopentolate concerning the onset of maximum cycloplegia and its duration (in Japanese, with English abstract)Ganka Rinsho Iho (Folia Ophthalmol Jpn)3617661769Google Scholar
  28. 28.
    Chat, SWS, Edwards, MH 2001Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in childrenOphthalmic Physiol Opt2187100PubMedCrossRefGoogle Scholar
  29. 29.
    Miranda, MN, Juan, S 1972Residual accommodation. A comparison between cyclopentolate 1% and a combination of cyclopentolate 1% and tropicamide 1%Arch Ophthalmol87515517PubMedGoogle Scholar
  30. 30.
    Gwiazda, J, Thorn, F, Bauer, J,  et al. 1993Myopic children show insufficient accommodative response to blurInvest Ophthalmol Vis Sci34690694PubMedGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2007

Authors and Affiliations

  • Ichiro Hamasaki
    • 1
  • Satoshi Hasebe
    • 1
  • Shuhei Kimura
    • 1
  • Manabu Miyata
    • 1
  • Hiroshi Ohtsuki
    • 1
  1. 1.Department of OphthalmologyOkayama University, Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesOkayamaJapan

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