The Short-term Effect of 1% Tropicamide Drop on Pupillary Diameter and İntraocular Pressure Change in Patients With Pseudoexfoliation Material

Abstract

Precis: In this study, in patients with pseudoexfoliation syndrome or glaucoma, changes in intraocular pressure and pupil size after %1 tropicamide used for pupil dilation, compared to healthy patients, were quantitatively demonstrated up to 4 hours after dilation. Purpose: To evaluate pharmacological dilatation with one drop of 1% tropicamide on pupillary diameter and intraocular pressure (IOP) changes in patients with pseudoexfoliation syndrome (PXS) and glaucoma (PXG). Methods: Eighty-two patients with PXS, 78 Patients with PXG, and 35 healthy subjects were included in the study. PXG and PXS were diagnosed based on IOP assessment, corneal pachymetry, optic disc examination, visual field testing, and peripapillary retinal nerve fiber analysis. IOP and the diameter of pupil size were measured before dilatation and at post dilatation 1st hour, 2nd, and 4th hours. Results: The mean pupillary diameter values at post-dilatation 2nd and 4th hours were statistically significantly different between the patients with PXS and PXG (P<0.001, for each). Also, there were significant differences between PXS group and control group in terms of the mean pupillary diameter values at pre-dilatation and post-dilatation at 1st hour and post-dilatation 2nd hour(P=0.007, P<0.001 respectively). The mean pupillary diameter at all times was statistically significantly different between PXG and control groups (P<0.001 for each). Significant IOP increases were observed in all groups after dilatation. The mean IOP at pre-dilatation and post-dilatation 4th hour were statistically significantly different between PXG and PXS groups (P=0.042, P<0.001, respectively). Whereas the mean IOP at pre-dilatation, post-dilatation 1st hour, post-dilatation 2nd hour, and post-dilatation 4th hour were statistically significantly different between PXG and control group (P<0.001 for each) Conclusion: Significant IOP increases have been observed in our study with 1% tropicamide in the PXG and PXS groups, with the peak effect at the 2nd hour in the post-dilatation period. Furthermore, the mean pupil diameter was found to be significantly lower in PXG patients compared to the control group.