Pupillary dilation to perform binocular indirect ophthalmoscopy and gain three dimensional evaluation of the disc, cup and macula is a routine part of optometric practice. However, many patients find the resulting photophobia and loss of near vision to be an inconvenience. Therefore, clinical interest in ophthalmic agents that will safely reverse the pharmacologically induced mydriasis and cycloplegia have existed for over fifty years. 0.5% dapiprazole HCL is a relatively new adrenergic agent reported to reverse the effects of pupillary dilation and cycloplegia secondary to tropicamide, phenylephrine hydrochloride and other analogs.2 To date, there have been no studies published to show the effects of dapiprazole on cyclopentolate, another popular cycloplegic/mydriatic agent. In this study, the clinical usefulness and efficacy of dapiprazole in reversing the effects of cyclopentolate were studied. A placebo in a masked (single blind) study was used. Bilateral cycloplegia was used to eliminate any residual accommodation that might have existed between the two eyes. Twenty seven subjects were tested: nine were used as controls, and eighteen were used as experimentals. The experimental group received two drops of dapiprazole administered five minutes apart in each eye 30 minutes after instillation of the cycloplegic drops. The control group received two drops of ocular lubricant administered five minutes apart. The diagnostic agents used for the experimental group were one drop each of 0.5% proparacaine and 1% cyclopentolate. Pupil diameter, amplitude of accommodation, and intraocular pressure were evaluated on each patient. These measurements were taken: (1) before instillation of the cycloplegic agents; (2) prior to instillation of dapiprazole (1 hour after cycloplegia); and (3) at 30, 60, 120, and 180 minutes after the final instillation of dapiprazole. Results indicated no significant difference on positive relative accommodation or negative relative accommodation, or pupil diameter, but with a statistically significant difference in the other variable: decreased lOP. Suggestive trends to dapiprazole's effects on cyclopentolate do exist that could be turned into statistical trends with an increase in number of test subjects and thier ages.
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