مقایسه میزان اتساع مردمک با فنیل‌افرین 5/2% و 5% با و بدون سیکلوپنتولات در درمانگاه چشم پزشکی بیمارستان حضرت رسول اکرم(ص)

The pupil should be dilated up to 6mm for eye examination, but systemic absorption of phenylepherin eye drop (PE) leads to serious complications. This study compared the effect of 2.5% and 5%PE with and without cyclopentolated 1% (CP) on pupillary dilation and pulse and blood pressure (BP) in patients refering to out patient clinic. Inorder to reach to a less toxic dose of PE. This is a prospective, crossover controlled clinical trial study since september 2000 to march 2001 on patients reffering to eye clinic, Selected patients were not on any medication or ocular and systemic diseases influencing on pupil or cardiovascular state. For each patient 6 phases tried, each one week apart. In the first phase pulse, BP and pupil diameter measured, then one drop of 2.5% PE instilled in lower culdesac of one eye and repeated after 5 minutes for 3 times. BP, pulse and pupil diameter measured 20, 30 and 45 minutes after the first drop. This procedure was repeated with 5% PE, CP 1%, artificial tear drop (control), 2.5% PE+CP and 5% PE+CE for second to sixth phase. Data collected compared and underwent statistical analysis with Paired T test. 97 patients, 11 to 70 years old (mean=42.43±1.93), 55% male had completed 6 phases of trial. Average systolic BP raise was 16.3 and 9.22mmHg and diastolic BP 5.41 and 3.75 mmHg for 5% and 2.5% PE respectfully, there was bradycardia of up to 9 pulse perminute, more in 5% PE group but these changes were not statistically significant (P>0.05). Pupil diameter increase was 1.35+0.75 mm with 2.5% PE. 1.95±0.95 with 5% PE, 3.9±0.95 with CP, 4.25±0.61 with 2.5% PE+CP and 4.55±0.58 mm with 5% PE+CP which is statistically significant (P0.05). There was no differences between 2.5% and 5% PE side effects on BP and pulse and dilation of pupil to 6mm statistically. Therfore 2.5% PE use in clinical practice is safe satisfactory and recommended.