Cycloplegic Refraction in Hyperopic Children: Effectiveness of a 0.5% Tropicamide and 0.5% Phenylephrine Addition to 1% Cyclopentolate Regimen
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Purpose: To evaluate the effectiveness of a cycloplegic regimen using 0.5% tropicamide and 0.5% phenylephrine(Tropherine, Hanmi Pharm), in addition to 1% cyclopentolate, in hyperopic children. Methods: The medical records of hyperopic patients below the age of 14 years who had undergone cycloplegicretinoscopy were retrospectively reviewed. Cycloplegic refractions were performed using one of two cycloplegicregimens. Regimen 1 was a Tropherine-added regimen comprising the administration of one dropof 1% cyclopentolate followed by two to three drops of Tropherine added at 15-minute intervals. Regimen 2was a cyclopentolate-only regimen comprising the administration of three to four drops of 1% cyclopentolateat 15-minute intervals. The mean difference between noncycloplegic and cycloplegic refraction was comparedbetween the two regimens. Results: A total of 308 eyes of 308 hyperopic children were included. The mean difference (±standard deviation)in the spherical equivalent (SE) between cycloplegic and noncycloplegic refraction was significantlylarger in regimen 2 than in regimen 1, with values of +1.70 ± 1.03 diopters (D) and +1.25 ± 0.89 D, respectively(p = 0.001). The SE change after cycloplegia was significantly different between the two regimens only in patientsaged 5 years or younger (p = 0.001), particularly in those with high hyperopia with an SE ≥5 D (p = 0.005)or fully accommodative esotropia (p = 0.009). There was no significant difference between the two regimens inpatients older than 5 years, regardless of the presence of high hyperopia or fully accommodative esotropia. Conclusions: The Tropherine-added regimen exerted a weaker cycloplegic effect than the cyclopentolate-onlyregimen, particularly in children under the age of 5 years with high hyperopia or fully accommodativeesotropia. However, the difference in refraction between the two regimens was small. A Tropherine-addedregimen can be effective in hyperopic children, with less associated discomfort than the instillation of cyclopentolate.
Abstract
Purpose: To evaluate the effectiveness of a cycloplegic regimen using 0.5% tropicamide and 0.5% phenylephrine(Tropherine, Hanmi Pharm), in addition to 1% cyclopentolate, in hyperopic children. Methods: The medical records of hyperopic patients below the age of 14 years who had undergone cycloplegicretinoscopy were retrospectively reviewed. Cycloplegic refractions were performed using one of two cycloplegicregimens. Regimen 1 was a Tropherine-added regimen comprising the administration of one dropof 1% cyclopentolate followed by two to three drops of Tropherine added at 15-minute intervals. Regimen 2was a cyclopentolate-only regimen comprising the administration of three to four drops of 1% cyclopentolateat 15-minute intervals. The mean difference between noncycloplegic and cycloplegic refraction was comparedbetween the two regimens. Results: A total of 308 eyes of 308 hyperopic children were included. The mean difference (±standard deviation)in the spherical equivalent (SE) between cycloplegic and noncycloplegic refraction was significantlylarger in regimen 2 than in regimen 1, with values of +1.70 ± 1.03 diopters (D) and +1.25 ± 0.89 D, respectively(p = 0.001). The SE change after cycloplegia was significantly different between the two regimens only in patientsaged 5 years or younger (p = 0.001), particularly in those with high hyperopia with an SE ≥5 D (p = 0.005)or fully accommodative esotropia (p = 0.009). There was no significant difference between the two regimens inpatients older than 5 years, regardless of the presence of high hyperopia or fully accommodative esotropia. Conclusions: The Tropherine-added regimen exerted a weaker cycloplegic effect than the cyclopentolate-onlyregimen, particularly in children under the age of 5 years with high hyperopia or fully accommodativeesotropia. However, the difference in refraction between the two regimens was small. A Tropherine-addedregimen can be effective in hyperopic children, with less associated discomfort than the instillation of cyclopentolate.
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