Pfeiffer N, Grehn F, Wellek S, Schwenn O
Départment of Ophthalmology, University of Mainz, Germany.
Ger J Ophthalmol. 1994 Nov;3(6):422-6.
In a placebo-controlled prospective study, thymoxamine 0.02% or acetylcholine 1.0% or thymoxamine 0.01% plus acetylcholine 0.5% were used intraocularly to reverse mydriasis during cataract surgery. Prior to surgery, pupils were dilated with scopolamine 0.25%, tropicamide 1%, and phenylephrine 10%. At the end of surgery, 228 eyes were randomly assigned to 1 of 4 different treatments: 57 eyes each received intracamerally thymoxamine 0.02%, acetylcholine 1%, a combination of both drugs, or placebo. At 5 min posttreatment, there was a significant mean pupillary constriction of 1.86 +/- 0.67 mm following acetylcholine administration and 1.53 +/- 0.80 mm following thymoxamine application as compared with the placebo group, in which the pupillary diameter remained almost constant. For the combination of acetylcholine plus thymoxamine the effect was fully additive, with a pupillary constriction of 3.42 +/- 0.98 and 4.04 +/- 1.02 mm being observed at 5 and 10 min posttreatment, respectively. No drug-related side effect was detected. We conclude that thymoxamine can be useful during surgery as an intraocular miotic to reverse mydriasis and can considerably enhance miosis when given in combination with acetylcholine.
在一项安慰剂对照的前瞻性研究中，白内障手术期间眼内使用0.02%的百里胺、1.0%的乙酰胆碱或0.01%的百里胺加0.5%的乙酰胆碱来逆转瞳孔散大。手术前，用0.25%的东莨菪碱、1%的托吡卡胺和10%的去氧肾上腺素散瞳。手术结束时，228只眼被随机分配到4种不同治疗方法中的一种：57只眼分别前房内注射0.02%的百里胺、1%的乙酰胆碱、两种药物的组合或安慰剂。治疗后5分钟，与安慰剂组相比，给予乙酰胆碱后平均瞳孔显著缩小1.86±0.67mm，给予百里胺后平均瞳孔显著缩小1.53±0.80mm，而安慰剂组瞳孔直径几乎保持不变。对于乙酰胆碱加百里胺的组合，其效果完全是相加的，治疗后5分钟和10分钟分别观察到瞳孔缩小3.42±0.98mm和4.04±1.02mm。未检测到与药物相关的副作用。我们得出结论，百里胺在手术期间作为眼内缩瞳剂可用于逆转瞳孔散大，并且与乙酰胆碱联合使用时可显著增强缩瞳作用。
