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Paper Information

Journal:   JOURNAL OF CURRENT OPHTHALMOLOGY   2005 , Volume 18 , Number 2; Page(s) 28 To 40.
 
Paper: 

ASSESSMENT OF THE NECESSARY NUMBER OF DROPS OF CYCLOPENTOLATE TO ACHIEVE ADEQUATE CYCLOPLEGIA

 
 
Author(s):  BAGHERI A.*, RABANIKHAH Z., GIVRAD S., SANAGOU M.
 
* LABBAFINEJAD HOSPITAL, SHAHID BEHESHTI UNIVERSITY OF MEDICAL SCIENCES
 
Abstract: 

Background: Cycloplegic refraction is an important test in strabismus patients and any patient with decreased vision.
The most commonly used drugs for this test are Atropine and Cyclopentolate. The drug which was more popular in the past was Atropine, which is still the standard against which other cycloplegic agents are compared. Nowadays Cyclopentolate is the drug of choice because it has many advantages as compared to atropine, including faster onset, shorter duration, reduced toxicity and ease of use.
This is now an open question as to what is an appropriate regimen of cyclopentenlote. In different references and among specialists, different opinions exist. Some believe that a single drop of cyclopentolate produces the adequate cycloplegia and some believe in two or even three drops to be adequate.
Purpose: In this research we tried to define how many drops of cyclopentolate can produce adequate cycloplegia without producing unwanted side effects.
Materials & Methods: We used data obtained from the 3 to 20 year old patients referring to strabismus clinic during one year (2003-2004). We divided the patients randomly into three groups and compared the results between one and two drops, one and three drops and two and three drops.
We also considered the factors that could be potential confounders, including age, sex, color and darkness of iris, type and amount of strabismus and the kind and amount of refractive error.
Results: 96 patients (192 eyes) were studied including 32 patients in group 1 and 33 patients is group 2 and 31 patients in group 3. They included 40 males (41.7%) and 56 females (58.3%) with mean age 11±5.7 years. 50 patients (52%) did not have strabismus but 46 patients (48%) had strabismus including 26 patients( 27.1%) with ET and 18 patients (18.8%) with XT. Two patinas (2.1%) had only hypertropia. 142 eyes (74%) were hyprope an 30 eyes (15.6%) were myope and 20 eyes (10.4%) were between a little hyperopia and myopia in two stages of the study. The effect of all factors including age, sex, iris color and darkness, presence of strabismus and its magnitude and type of refractive error and its magnitude and spherical equivalent were evaluated and were not significant in different groups. The study also showed that side effects were more prevalent using more frequent drops.
Conclusion: The study showed that considering all these factors that could have been potential confounders, the adequate dose of cyclopentolate is one drop, meaning that in any patient who is candidate for doing cycloplegic refraction, using a single drop of cyclopentolate 1% suffices. We also reached the conclusion that there are less side effects using one drop of cyclopentolate, compared to two or three drops.

 
Keyword(s): REFRACTION, AUTOREFRACTION, CYCLOPENTOLATE, CYCLOPLEGIA, CYCLOPLEGICS
 
References: 
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