Hung Kuo-Chi, Huang Hsiu-Mei, Lin Pei-Wen
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Taiwan J Ophthalmol. 2015 Jul-Sep;5(3):124-127. doi: 10.1016/j.tjo.2015.06.001. Epub 2015 Aug 24.
To evaluate the effect of cycloplegic mydriasis with 1% cyclopentolate and 1% tropicamide on the intraocular pressure (IOP) and refractive status of children for cycloplegic refraction and compare the [OP and refractive changes between hyperopic and myopic groups.
This study was designed as a retrospective cohort study. Ninety one children received cycloplegic mydriasis. The IOP was measured with a noncontact tonometer before cycloplegic administration. One drop of 1% cyclopentolate was administered, which was followed by two drops of 1% tropicamide at an interval of 10 minutes. The IOP was then measured 30 minutes after tropicamide instillation. Autorefraction was assessed with an autorefractometer before and after cycloplegic mydriasis.
The mean age of the 44 girls and 47 boys was 7.3 ± 2.4 years. The mean precycloplegic IOP was 14.45 ± 2.47 mmHg and the mean postcycloplegic IOP was 15.06 ± 3.08 mmHg in all eyes. A significant difference was noted in the IOP change ( = 0.033). In the 39 hyperopic eyes, the mean precycloplegic IOP and postcycloplegic IOP were 14.54 ± 2.53 mmHg and 15.69 ± 3.35 mmHg, respectively. There was a significant difference in the IOP change ( = 0.008). In the 52 myopic eyes, the mean precycloplegic IOP and postcycloplegic IOP were 14.38 ± 2.44 mmHg and 14.61 ± 2.80 mmHg, respectively ( = 0.72). There was no significant IOP change in the myopic group. The postcycloplegic IOP was significantly different between the hyperopic and the myopic groups ( = 0.021). Three eyes (3.3%) had an IOP elevation more than 5.0 mmHg after cycloplegic mydriasis. Postcycloplegic refraction showed significant hyperopic shifts in all eyes ( < 0.0001).
Cycloplegic mydriasis with 1% cyclopentolate and 1% tropicamide caused IOP changes in preschool and school-aged children with hyperopia. Ophthalmologists should be very cautious in monitoring IOP changes for children with cycloplegic medication use.
评估1%环喷托酯和1%托吡卡胺睫状肌麻痹散瞳对儿童睫状肌麻痹验光时眼压（IOP）及屈光状态的影响，并比较远视组和近视组之间的眼压及屈光变化。
本研究设计为回顾性队列研究。91名儿童接受了睫状肌麻痹散瞳。在给予睫状肌麻痹药物前，使用非接触眼压计测量眼压。滴入一滴1%环喷托酯，随后每隔10分钟滴入两滴1%托吡卡胺。在滴入托吡卡胺30分钟后测量眼压。在睫状肌麻痹散瞳前后，使用自动验光仪评估自动验光结果。
44名女孩和47名男孩的平均年龄为7.3±2.4岁。所有眼睛的平均散瞳前眼压为14.45±2.47mmHg，平均散瞳后眼压为15.06±3.08mmHg。眼压变化有显著差异（P=0.033）。在39只远视眼中，平均散瞳前眼压和散瞳后眼压分别为14.54±2.53mmHg和15.69±3.35mmHg。眼压变化有显著差异（P=0.008）。在52只近视眼中，平均散瞳前眼压和散瞳后眼压分别为14.38±2.44mmHg和14.61±2.80mmHg（P=0.72）。近视组眼压无显著变化。远视组和近视组散瞳后眼压有显著差异（P=0.021）。3只眼（3.3%）在睫状肌麻痹散瞳后眼压升高超过5.0mmHg。散瞳后验光显示所有眼睛均有显著的远视性偏移（P<0.0001）。
1%环喷托酯和1%托吡卡胺睫状肌麻痹散瞳会引起远视学龄前和学龄儿童眼压变化。眼科医生在监测使用睫状肌麻痹药物儿童的眼压变化时应非常谨慎。
