Suvendu Das1, Somnath Maity2, Tanmoy Kanti Goswami3
1Department of Ophthalmology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
2Department of Pharmacology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
3Department of Pharmacology, NRS Medical College and Hospital, Kolkata, West Bengal, India



Background: Mydriatics are essentially used in routine ophthalmoscopic examinations and before various eye surgeries. Because pupil is under the control of autonomic nervous system, a combination of parasympatholytic drug (tropicamide) and sympathomimetic agent (phenylephrine) causes greater pupillary dilatation. In postdacryocystorhinostomy (DCR) patients, the nasolacrimal passage becomes wider and shortened, so the chances of absorption of topical drugs as well as the diminished local effects such as mydriasis are higher than normal. Hence, there are more chances of systemic adverse reactions. Materials and Methods: Data were collected and compared between fifty patients with unilateral nasolacrimal duct obstruction scheduled for DCR. Normal eye served as the control group, whereas affected post-DCR eye was considered the study group. Local (mydriasis) and systemic effects of the combination drop of tropicamide 0.8% (w/v) and phenylephrine 5% (w/v) were assessed. Results: Mydriasis was lesser in the post-DCR eyes (P < 0.001 for both vertical and horizontal papillary diameters). There were no statistically significant changes in systemic vital parameters when measured before and after the application of the combination drop in both the groups. Conclusions: The combination of tropicamide and phenylephrine can be safely used in post-DCR eyes as mydriatics, although mydriasis is lesser due to rapid drainage.

Keywords: Dacryocystorhinostomy, mydriasis, nasolacrimal duct, phenylephrine, tropicamide

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