| Part oneThe effect of three types of muscarinic receptor antagonists on accommodation of myoic adultsObjective To investigate the effect of three types of muscarinic receptor antagonists on accommodation of myopic adults.Methods 19 healthy myopic adults were enrolled in this self-controlled study. All eyes of the 19 were instilled 2.5% cillimycin and three types of muscarinic receptor antagonists:1% cyclopentolate hydrochloride,0.05% racanisodamine eye drop,0.5% tropicamide during the study with at least a 4-day washout-period between each treatment to rule out the effect of the previous agent.2.5% cillimycin was used as the control drug.(Two drops of each agent were applied in a 5-minute interval in both eyes(first the right eye then the left one within a 5-minute interval), each time with a single drop.) All eyes were treated with each drug twice in a 5-minute interval with one drop each time. Scotopic pupil sizes of both eyes and amplitude of accommodation of the right eye were measured before and 10,20,30,45,60, 75,90and120 minutes after treatment. Scotopic pupil sizes were evaluated with an Topcon autorefractor. Amplitude of accommodation was measured by minus-lens test on the RT-5100 comprehensive refractometer. The data were analyzed using the SAS version 9.2. Scotopic pupil sizes and amplitude of accommodation among four treatments were evaluated with one-way analysis of variance (ANOVA). The minimum amplitude of accommodation between 1% cyclopentolate hydrochloride and 0.5% tropicamide.0.05% racanisodamine eye drop and 2.5% cillimycin were evaluated with t test. P value of<0.05 was considered statistically significant. Results 1. The effect of pupil dilatation:120 minutes after 1% cyclopentolate hydrochloride and 0.5% tropicamide installation,the pupil sizes were enlarged to the peak size and approximately 1.34±0.81mm and 1.59±0.89mm larger respectively compared with the pupil size of the eyes before treated.10 minutes after 0.05% racanisodamin eye drop installation,the pupil size became smaller and maintained for the next 20 minutes. Then it recovered to baseline value at 45 minutes and continued to enlarge to a peak size of approximately 0.63±0.30mm larger than baseline value at 120 minutes.The pupil size became smaller in 2.5% cillimycin-treated eyes and the minimum pupil size was 0.27±0.15mm smaller than baseline value at 10 minutes. The scotopic pupil sizes after treatment of four drugs were significantly different; 2. The effect of cycloplegia:The effect of 1% cyclopentolate hydrochloride on accommodation started at 10 minutes after the last drop.The amplitude of accommodation at 60 minutes and 120minutes were 2.01±1.20D and 1.67±0.85D respectively. The amplitude of accommodation at 120 minutes was minimum. The effect of 0.5% tropicamide on accommodation started at 10 minutes after the last drop,the minimum amplitude of accommodation (1.94±0.72D) was measured at 30 minutes after the last dropand the effect of 0.5% tropicamide on cycloplegia became weaker 60 minutes after the last drop. The amplitude of accommodation at 60 minutes and 120minutes were 2.05±0.70D and 3.75±1.52D respectively. There was no significant difference between the two drugs. The minimum amplitude of accommodation of 0.05% racanisodamine eye drop and 2.5% cillimycin were 9.48±2.21D and 9.56±3.28D respectively. There was no significant difference between the two drugs.Conclusions 1.The effect of 1% cyclopentolate hydrochloride on cycloplegia is not obviously superior to 0.5% tropicamide,but its effect on cycloplegia lasts longer. So 1% cyclopentolate hydrochloride is advised when the patient should wait for more than 1hour before the refraction can be attained.2.0.05% racanisodamine eye drop has a significant impact on mydrasis and no obvious effect on cycloplegia. Part twoThe effect of three types of muscarinic receptor antagonists on ocular aberrations of myopic adultsObjective To investigate the effect of three types of muscarinic receptor antagonists on ocular aberrations of myopic adults.Methods 12 healthy myopic adults were enrolled in this self-controlled study. All eyes of the 12 sbujects were instilled 2.5% cillimycin and three types of muscarinic receptor antagonists:1%cyclopentolate hydrochloride,0.05% racanisodamine eye drop,0.5% tropicamide during the study with at least a 4-day wash-period between each treatment to rule out the effect of a previous agent.2.5% cillimycin was used as the control drug.(Two drops of each agent were applied in a 5-minute interval in both eyes(first the right eye then the left one within a 5-minute interval), each time with a single drop.) All eyes were treated with each drug twice in a 5-minute interval with one drop each time.Human ocular aberrations were measured before and 30minutes after treatment by Schwind ORK Wavefront Analyzer.At the pupil analyzing diameter of 4.0 mm,5.0 mm and 6.0 mm, the values of the root-mean-square(RMS) of general (RMSg) and higher-order (RMSh), the root-mean-square(RMS) of the third and fourth,coma, spherical aberration were analyzed. The data were analyzed using the SASversion 9.2.Repeated measures ANOVAs were used for statistical analyses with a p value of<0.05 being considered as statistically significant.Results 1. The RMSg, RMSh, RMS3, RMS4,coma and spherical aberrations became larger as the pupil analyzing diameter became bigger. Except for spherical aberation after 2.5% cillimycin intervention a significant difference was found among different pupil diameters (P<0.05).2. At the pupil diameter of 6.0 mm,the spherical aberration was 0.07±0.11μm in undilated eyes, and0.10±0.10μm,0.08±0.11μm, 0.07±0.120μm,0.05±0.12μm after installation of 1% cyclopentolate hydrochloride,0.5% tropicamide,0.05% racanisodamine eye drop and 2.5% cillimycin.Compared with the spherical aberration in the untreated eyes, spherical aberration with applying muscarinic receptor antagonists such as 1% cyclopentolate hydrochloride and 0.5% tropicamide seemed to shift in a positive direction,while the spherical aberration in 0.05% racanisodamine-treated eyes did not change.But there was no significant difference in the spherical aberration among those drugs treatment analyzed by ANOVA.Conclusions The effect of 1% cyclopentolate hydrochloride and 0.5% tropicamide on ocular aberrations,especially spherical aberration,should be paid more attention if they are used before refractive surgery. |
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