Johnson M E, Molinari J F, Carter J
J Am Optom Assoc. 1993 Sep;64(9):629-33.
Clinical interest in ophthalmic agents to reverse pharmacologically induced mydriasis safely has been attempted for over fifty years. These agents may aid practitioners in assisting the younger patient to regain unable near visual function.
We evaluated the usefulness of dapiprazole in a private clinical setting. Our study was doubled masked, randomized and used one eye of each subject as a control. Twenty-six consecutive subjects were given dapiprazole as directed by its manufacturer. This administration of dapiprazole followed bilateral pupil dilation with proparacaine 0.5%, hydroxyamphetamine 1.0% and tropicamide 0.25%. Pupil diameter, amplitude of accommodation, intraocular pressure and conjunctival injection were each evaluated prior to instillation of the diagnostic agents, immediately before the instillation of dapiprazole and at 30, 60, 120, and 180 minutes after the final instillation of dapiprazole.
The average pupillary recovery time for dapiprazole-treated eyes was similar to previously published data. Accommodation also showed significant recovery, with comfortable reading ability returning by approximately 45 minutes.
The design of our study did not permit us to determine what portion of accommodation recovery if any was attributable to a ciliary muscle effect and what portion may have resulted from the increased depth of field attending pupillary constriction.
五十多年来,人们一直试图从临床上寻找能安全逆转药物性散瞳的眼科药物。这些药物可能有助于从业者帮助年轻患者恢复近视力功能。
我们在私人临床环境中评估了达哌拉唑的效用。我们的研究采用双盲、随机设计,将每个受试者的一只眼睛作为对照。按照达哌拉唑制造商的指示,连续26名受试者使用了该药。在使用0.5%丙美卡因、1.0%羟苯丙胺和0.25%托吡卡胺进行双侧瞳孔扩张后,给予达哌拉唑。在滴入诊断药物前、滴入达哌拉唑前以及滴入达哌拉唑后30、60、120和180分钟,分别评估瞳孔直径、调节幅度、眼压和结膜充血情况。
达哌拉唑治疗眼的平均瞳孔恢复时间与先前发表的数据相似。调节功能也有显著恢复,大约45分钟后恢复到舒适的阅读能力。
我们的研究设计不允许我们确定调节功能恢复的哪一部分(如果有的话)归因于睫状肌效应,以及哪一部分可能是由于瞳孔收缩导致的景深增加所致。