Abstract

USE OF CYCLOPLEGIC AND MYDRIATIC AMONG SUCCESSFUL POSTDACRYOCYSTORHINOSTOMY CASES: HOW SAFE IT IS!!

Author(s): Santanu Sinha Babu1

BACKGROUND In post dacryocystorhinostomy patients, absorption of topical drugs is higher due to exposed nasal mucosa. As a result, systemic side effects are more common than local effects. So, ophthalmologists must be aware of the dangers of ocular and systemic side effects of these combined drugs especially in patients with cardiovascular, renal and other morbidities which are sometimes really challenging. The main purpose of the study is to assess the safety of giving a mixture containing 0.75% tropicamide and 2.5% phenylephrine among the successful post DCR cases in normotensive and hypertensive patients, to find out whether shortening of the nasolacrimal passage which occurred after DCR surgery has any effect on the absorption and systemic effects of ocular drops and record the difference of these complications (local and systemic) in pre- and post-operative DCR sides with that of the normal sides. METHODS Fifty patients of successful post dacryocystorhinostomy cases were studied between February 2018 and January 2019. On admission, pupillary diameter, pulse rate, blood pressure, ECG changes were measured before and after application of drops and same procedures were done one and half month after DCR operation. This is a non-randomized control trial designed to determine the safety of use of cycloplegic and mydriatic among the successful post dacryocystorhinostomy cases. RESULTS The size of pupillary diameter was less in post DCR side compare to control side (p=0.000). Both blood pressure (p=<0.05) and pulse rate changes were also seen but pulse rate changes was statistically insignificant (p=0.302). Significant ECG changes were seen in hypertensive patients. CONCLUSIONS Removal of obstruction and shortening of nasolacrimal passage by DCR surgery causes alteration of transportation and absorption of drugs. So, before its application, pharmacodynamics and systemic adverse effects of applied drugs should be kept in mind.