Combination Cyclopentolate and Phenylephrine for Mydriasis in Premature Infants With Heavily Pigmented Irides

Abstract

Purpose: This study examined whether safe and effective mydriasis can be achieved in premature infants with heavily pigmented irides using combination cyclopentolate 0.2% and phenylephrine 1% eyedrops. Methods: A prospective, randomized double-blind study was performed to compare combination cyclopentolate 0.2% and phenylephrine 1% eyedrops with triple instillation of tropicamide 0.5% and phenylephrine 2.5%. Twenty-eight consecutive babies with dark irides and birthweight <1600 g referred for screening for retinopathy of prematurity comprised the study population. Infants' eyes were randomly dilated twice with both regimens within a 2-week period. Blood pressure, heart rate, and pupil size were measured. Results: Good mydriasis was achieved in both groups with no significant differences in pupil size or blood pressure (systolic, diastolic, or mean arterial pressures) over starting baseline values. Pulse rates decelerated below the baseline values in both groups, but these differences were not large. Conclusion: The single combination eyedrop of cyclopentolate 0.2% and phenylephrine 1% is as effective and safe a mydriatic for infants with dark irides as both tropicamide 0.5% and phenylephrine 2.5%. Journal of Pediatric Ophthalmology and Strabismus 2000;37:15-20.

Low dose or very low dose phenylephrine and cyclopentolate microdrops for retinopathy of prematurity eye examinations (The Little Eye Drop Study): a randomised controlled non-inferiority trial

“…Previous studies have suggested that infants with dark iris pigmentation may require higher mydriatic doses,14–16 however we found that iris pigment did not have an impact on ease of screen or ROPEE success rate.…”