Abstract
We conducted a randomized, blind study of pupillary dilating capabilities and associated systemic cardiovascular effects of 3 solutions. Thirty babies <1500gms at birth were studied at 6-8 weeks. Group A (n=10) received phenylephrine 2.5% and tropicamide 1.0%; Group B (n=10) received phenylephrine 2.5%, tropicamide 0.5% and cyclopentolate 0.5%; Group C (n=10) phenylephrine 1.0% and tropicamide 1.0%. One drop was placed in each eye and repeated 5 minutes later. Pupillary dilation was measured with a metric ruler by direct observation at one hour. BP and heart rate were monitored, using an oscillometer, immediately prior to the instillation of the drops and at 5 minute intervals for the following 60 minutes. BP and heart rate increased transiently in all groups but returned to baseline values within 15 min. No significant differences were found between groups. “Postdrop” pupillary size was largest in Group A but the differences were not significant. On exposure to bright light, the pupillary size in Group C was significantly smaller than Groups A or B (7.35±0.59mm, 7.23±0.38mm and 6.75±0.57mm in Groups A, B and C, p<.01). Nevertheless dilatation was adequate in 9/10 Group C babies. Solutions containing 2.5% phenylephrine are most effective for use in LBW infants and are free from significant cardiovascular side effects. However, solutions containing 1% (phenylephrine) provide adequate dilation in most babies.
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Sindel, B., Baker, M., Maisels, M. et al. 1522 A COMPARISON OF THE PUPILLARY AND CARDIOVASCULAR EFFECTS OF VARIOUS MYDRIATIC AGENTS IN THE NEWBORN INFANT. Pediatr Res 19, 364 (1985). https://doi.org/10.1203/00006450-198504000-01546
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DOI: https://doi.org/10.1203/00006450-198504000-01546