Miyata Eye Hospital, Miyazaki, Japan.
Clin Exp Ophthalmol. 2011 Jul;39(5):456-61. doi: 10.1111/j.1442-9071.2010.02456.x. Epub 2011 Jan 14.
This study investigated the efficacy and safety of intracameral injection of commercially available eye drops containing 0.5% tropicamide and 0.5% phenylephrine hydrochloride (Mydrin-P, Santen Pharmaceutical, Osaka, Japan).
In vitro experiment and prospective clinical study at a private hospital.
Mydrin-P was applied to confluent cultured human corneal endothelial cells, and the cellular morphology was examined. Clinical study subjects were 65 eyes of 65 patients that underwent phaco-emulsification and aspiration with intraocular lens implantation and received intracameral injection of Mydrin-P for poor mydriasis after preoperative topical instillation of mydriatics (intraocular mydriasis group; with five subgroups based on cause: diabetes, pseudo-exfoliation, post-surgery, uveitis, unknown). Controls, comprising 39 eyes of 39 patients, were not injected with Mydrin-P.
The ratio of pupillary diameter to corneal diameter was determined before and after injection of Mydrin-P. Corneal endothelial density was measured preoperatively and 3 months and 1 year postoperatively.
Pupillary diameter and corneal endothelial density.
Human corneal endothelial cell morphology was unaltered after Mydrin-P injection. The mean ratio of the pupillary diameter to corneal diameter increased in the intraocular mydriasis group (before: 54.2 ± 4.8%, after: 58.4 ± 6.6%; P < 0.001) and in the diabetes and unknown subgroups. The corneal endothelial cell density reduction rate 3 months and 1 year after surgery was not significantly different between the intraocular mydriasis group and controls.
Intracameral injection of Mydrin-P appears to be effective and safe for dilating the pupil in cases with poor mydriasis after preoperative instillation of mydriatics.
本研究旨在探讨 commercially available eye drops containing 0.5% tropicamide and 0.5% phenylephrine hydrochloride（Mydrin-P，Santen Pharmaceutical，大阪，日本）在眼前房内注射的疗效和安全性。
体外实验和私立医院的前瞻性临床研究。
Mydrin-P 应用于汇合培养的人角膜内皮细胞，观察细胞形态。临床研究对象为 65 例 65 眼患者，这些患者均接受超声乳化白内障吸除术联合人工晶状体植入术，并在术前局部滴用散瞳药后出现瞳孔散大不良，给予眼前房内注射 Mydrin-P（眼内散瞳组；根据病因分为 5 个亚组：糖尿病、假性剥脱综合征、术后、葡萄膜炎、原因不明）。对照组包括 39 例 39 眼，未注射 Mydrin-P。
注射 Mydrin-P 前后测量瞳孔直径与角膜直径的比值。术前和术后 3 个月、1 年测量角膜内皮细胞密度。
瞳孔直径和角膜内皮细胞密度。
人角膜内皮细胞形态在 Mydrin-P 注射后无变化。眼内散瞳组（术前：54.2±4.8%，术后：58.4±6.6%；P<0.001）和糖尿病及原因不明亚组的平均瞳孔直径与角膜直径比值均增加。术后 3 个月和 1 年，眼内散瞳组和对照组的角膜内皮细胞密度下降率无显著差异。
对于术前滴用散瞳药后出现瞳孔散大不良的患者，眼前房内注射 Mydrin-P 似乎是一种有效且安全的扩瞳方法。
