Evaluation of cycloplegic effectiveness of cyclopentolate and atropine

Background Cycloplegia is well accepted for the first refraction estimate in childhood.Yet no good evidence is offered in terms of which cyclopegia is preferable for the different ages and refractive status in children. Objective This study aimed to compare the effectiveness of cycloplegia between 1％ cyclopentolate and 1％ atropine sulphate before optometry in ametropia children. Methods This was a prospective clinical trail.The self matched-pairs control randomly observation was designed.One hundred and sixty eyes of 80 children of 4-9 years old with refractive error were recruited in this study.1％ cyclopentolate eye drops were topically administered once per 5 minutes for 3 times and 1％ optometry was performed 45 minutes after eye dropping.Three days after that,1％ atropine then was used 3 times per day for consecutive 3 days and again the refractive diopter was obtained.The differences of the results in autorefraction,retinoscope and residual accommodation were compared between 1％ cyclopentolate and 1％ atropine eye drops.This trail was approved by the Ethic Committee and written informed consent was obtained from each custodian. Results The autorefraction values were ( 0.55 ±3.52 ) D and ( 2.22 ±3.52) D before and after the administration of 1％ atropine with the difference value( 1.66± 1.62) D (t =13.02,P =0.00 ).The autorefraction value was( 1.74±3.46 ) D after dropping of 1％ cyclopentolate and the difference value from that of 1％ atropine was (0.48 ± 0.46) D ( t =13.08,P =0.00 ).The cy(e)lplegic autorefractions of atropine and cyclopentolate have strong correlation ( R2 =0.98,P =0.000 ).The residual accommodation values were ( 0.32± 0.44 )D and(0.05±0.41 ) D after dropping of 1％ cyclopentolate and 1％ atropine with the difference( 0.27±0.55 ) D ( t =4.56,P =0.00 ).The difference value of refractive diopter was (0.31 ± 0.37 )D in myopic group,(0.56±0.48 )D in moderate hypermetropic group and(0.59±0.50)D in high myopic group,and that of myopic group was significantly lower than the moderate hypermetropic group ( t =- 3.14,P =0.00 ).No significant difference was found in the autorefraction difference between 4-6 years group and 7 -9 years group [ ( 0.61 ±0.53 ) D vs ( 0.49 ±0.39 ) D ] ( t =1.21,P=0.23 ).The hidden value because of accommodation had weak correlation with the difference value between atopine and cyclopentolate(r=0.43,P=0.00). Conclusions Both 1％ atropine and 1％ cyclopentolate have the cycloplegic effects.This study suggestes that 1％ atropine should be used for the optometry of hypermetropia children. Key words: Optometry;  Cyclopentolate;  Atropine;  Cycloplegic;  Residual accommndation