Dhivya Ashok Kumar1, Amar Agarwal2, Maheswari Srinivasan1, Jyothi Narendrakumar1, Akshaya Mohanavelu1, Keerthana Krishnakumar1. 1. From Dr. Agarwal's Eye Hospital and Eye Research Centre (Kumar, Agarwal) and the Shri Prakash Institute of Optometry (Srinivasan, Narendrakumar, Mohanavelu, Krishnakumar), Chennai, India. 2. From Dr. Agarwal's Eye Hospital and Eye Research Centre (Kumar, Agarwal) and the Shri Prakash Institute of Optometry (Srinivasan, Narendrakumar, Mohanavelu, Krishnakumar), Chennai, India. Electronic address: dragarwal@vsnl.com.
Abstract
PURPOSE: To analyze the pharmacological mydriasis and the consequent fundus visibility after single-pass 4-throw pupilloplasty in pseudophakic eyes. SETTING: Dr. Agarwal's Eye Hospital, Chennai, India. DESIGN: Comparative case series. METHODS: Patients with bilateral pseudophakia with single-pass 4-throw pupilloplasty in 1 eye (study) and no single-pass 4-throw in the fellow eye (control) were included. The pupil measurements were analyzed before and after the instillation of mydriatics (tropicamide 0.8%-phenylephrine 5.0% and atropine 1.0%). The dimensions at the baseline and 40, 90, and 120 minutes after instillation were quantified by anterior-segment optical coherence tomography (Visante), a corneal topographer (Orbscan 11z), and an autorefractometer (HRK-7000). The serial photograph (DC3 digital camera) and the fundus imaging (TRC.50DX) were recorded. Changes in pupil size, area, and fundus visibility (50 degrees); the difference in mydriasis between the drugs; and a comparison of mydriasis with the fellow eyes were recorded. RESULTS: The study comprised 22 patients (22 study eyes and 22 control eyes). There was a significant increase in pupil size and area over time (P < .0001). The occurrence of mydriasis was higher in the vertical axis (mean 4.5 mm ± 1.3 [SD]) than in the horizontal axis (mean 4.0 ± 1.3 mm) with a significant difference (P = .021). There was a statistically significant difference in pupil dilation between the study eyes and the control eyes (P = .002). The fundus imaging showed good illumination in 13 eyes (59%) and defective illumination in 9 eyes (41%) for retinal visibility. CONCLUSION: Although pharmacological pupil mydriasis was not equivalent to normal eyes, significant mydriasis occurred and aided in fundus visualization after single-pass 4-throw pupilloplasty.
PURPOSE: To analyze the pharmacological mydriasis and the consequent fundus visibility after single-pass 4-throw pupilloplasty in pseudophakic eyes. SETTING: Dr. Agarwal's Eye Hospital, Chennai, India. DESIGN: Comparative case series. METHODS:Patients with bilateral pseudophakia with single-pass 4-throw pupilloplasty in 1 eye (study) and no single-pass 4-throw in the fellow eye (control) were included. The pupil measurements were analyzed before and after the instillation of mydriatics (tropicamide 0.8%-phenylephrine 5.0% and atropine 1.0%). The dimensions at the baseline and 40, 90, and 120 minutes after instillation were quantified by anterior-segment optical coherence tomography (Visante), a corneal topographer (Orbscan 11z), and an autorefractometer (HRK-7000). The serial photograph (DC3 digital camera) and the fundus imaging (TRC.50DX) were recorded. Changes in pupil size, area, and fundus visibility (50 degrees); the difference in mydriasis between the drugs; and a comparison of mydriasis with the fellow eyes were recorded. RESULTS: The study comprised 22 patients (22 study eyes and 22 control eyes). There was a significant increase in pupil size and area over time (P < .0001). The occurrence of mydriasis was higher in the vertical axis (mean 4.5 mm ± 1.3 [SD]) than in the horizontal axis (mean 4.0 ± 1.3 mm) with a significant difference (P = .021). There was a statistically significant difference in pupil dilation between the study eyes and the control eyes (P = .002). The fundus imaging showed good illumination in 13 eyes (59%) and defective illumination in 9 eyes (41%) for retinal visibility. CONCLUSION: Although pharmacological pupil mydriasis was not equivalent to normal eyes, significant mydriasis occurred and aided in fundus visualization after single-pass 4-throw pupilloplasty.