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Article Abstract

Objective: To investigate the peak time of refractive error obtained by Cyclopentolate Hydrochloride 1.0% (Cyclopentolate 1.0% for short) and Cyclopentolate 1.0% combined with Proparacaine Hydrochloride 0.5% (Proxymetacaine) and to compare the refractive error obtained by Cyclopentolate 1.0% and Atropine 1.0% in the children with hyperopia.

Methods: Seventy one children (141 eyes) with hyperopia (mean age 7.9 ± 2.1) were divided into two groups randomly according to the different cycloplegic methods:group A (Pro+Cyc group) and group B (NS+Cyc group). There were 34 patients (67 eyes) in group A and 37 patients (74 eyes) in group B. One drop of Proparacaine Hydrochloride 0.5% or physiological saline was used respectively in group A and group B, five minutes before three drops of Cyclopentolate 1.0% were given at intervals of ten minutes. Cycloplegic autorefraction and pupil diameter were compared at 30, 40, 50, 60, 70minutes after the first drop of Cyclopentolate 1.0% was given in both A and B groups. Atropine 1.0% was used in both groups one week later for three days with three times per day (group A' and group B'). Cycloplegic autorefraction and pupil diameter were compared between group A and A, ' and group B and B', respectively.

Results: The peak time of cycloplegic autorefraction was 50 minutes after the first drop of cyclopentolate 1.0% in group A, while the peak time was 60 minutes in group B. The maximal cycloplegic autorefraction of group A was significantly lower than that in group A' [(+4.44 ± 2.34) D vs. (+4.86 ± 2.26) D, t = 11.16, P < 0.01]. The maximal cycloplegic autorefraction of group B was significantly lower than that in group B' [(+4.50 ± 2.19) D vs. (+5.04 ± 2.10) D, t = 11.44, P < 0.01]. The difference of cycloplegic autorefraction between group A' and the peak refraction of group A was less than the difference between group B' and the peak refraction of group B [(0.42 ± 0.32) D vs. (0.54 ± 0.39) D, t = -1.99, P = 0.048]. The peak time of pupil diameter is 50 minutes after the first drop of cyclopentolate 1.0% in group A, while the peak time of pupil diameter is 60 minutes in group B. The time course of cycloplegic was consistent with mydriasis.

Conclusion: In 3 to 14 years old Chinese hyperopia children, using cyclopentolate 1.0% three drops for optometry examination, the maximal cycloplegic autorefraction can be measured from 50 minutes to 70 minutes after the first drop of Cyclopentolate 1.0%. The Cyclopentolate 1.0% can achieve the peak time of refraction 10 minutes early as well as increase the effect of mydriasis when it is used combined with topical anaesthetic. Cyclopentolate 1.0% can be used for the optometry examination in the hyperopia children. However neither Cyclopentolate 1.0% nor Cyclopentolate 1.0% combined with Proparacaine Hydrochloride 0.5% can instead of the use of Atropine 1.0%.

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