Efficacy of topical tropicamide 1% versus a combination of tropicamide 0.8% and phenylephrine 5% for cycloplegia

In ophthalmic practice, cycloplegia were required on a regular basis for refraction and fundus evaluation. A well dilated pupil helps the refraction to be carried out more easily and accurately, and also allows a thorough examination of the lens and fundus.

To compare 1% tropicamide solution with a combination of 0.8% tropicamide and 5% phenylephrine for the degree of cycloplegia and the amount of residual accommodation at 20 minutes after instillation of the drop.

In this prospective, randomized study, 150 patients who presented to the department of Ophthalmology were evaluated for cycloplegia. They received 1 deop of Tropicamide 1% in one eye and the combination drop in the other eye. The cyclopleiga and residual accommodation were assessed at 20 minutes using the autorefractometer.

In the eyes that received Tropicamide 1%, the mean cycloplegia measured at 20 minutes was 1.12 D and the mean residual accommodation was 1.20 D. In the eyes that received the combination drop, the mean cycloplegia was 1.05 D and the mean residual accommodation was 1.26 D. Though the cyclopegic effect of tropicamide 1% was marginally better than the combination drop, the difference in the two groups was not statistically significant for cycloplegia (p=0.07) or residual accommodation (p=0.15).

A single drop of a combination of 0.8% Tropicamide and 5% Phenylephrine achieves adequate cycloplegia in patients between 11–40 years of age.