DETERMINING THE TIME REQUIRED TO ACHIEVE PEAK CYCLOPLEGIC EFFECT OF CYCLOPENTOLATE 1% IN CHILDREN

*Maiss George Rajjouh, MD, Yusuf Suleiman and Mahmoud Rajab

ABSTRACT

The aim of the study: To determine the time required to achieve peak cycloplegic effect of cyclopentolate 1% with the application of local anesthetic drops in children, and evaluate the correlation between this time and each of pupillary reaction, pupillary diameter and refractive status of the patient, and to study the side effects of Cyclopentolate 1% eye drops. Materials and Methods: This was an analytical cross-sectional study involving children aged 4 to 14 years with dark irises who attended to ophthalmology clinic at Tishreen University Hospital in Lattakia. One drop of Benoxinate 0.4% (Oxybuprocaine) (trade name: medecain 0.4%) was instilled, then after 3 minutes Cyclopentolate 1% was instilled into both eyes three times at 5 minutes intervals. The spherical equivalent, pupillary reaction, and pupillary diameter were recorded before the first drop and 13 times after the last drop at 5-minute intervals. The time required to achieve peak cycloplegic effect was defined as the time point at which the spherical equivalent reached and remained within the equivalence limit (0.25 D) of the final value at 80 minutes. Results: 128 children (256 eyes) were enrolled in this study. Their mean age was 9.96±2.5 years (range: 4-14 years). The time required to achieve peak cycloplegic effect was 30 minutes after the first drop of cyclopentolate. A poor correlation was observed between the time of peak cycloplegic effect and the pupillary reaction (r= 0.08). And the peak cycloplegic effect was reached earlier than the maximum pupillary dilatation. Conclusion: In most children, the peak Cycloplegic effect of Cyclopentolate was 30 minutes after the first instillation of cyclopentolate. The absence of a pupillary reaction or the maximum pupillary dilatation should not be used as an indicator of maximum cycloplegia.

Keywords: Cycloplegia, Refractive Errors, Medecain, Cyclopentolate, Dark Irises.