The effect of 1% tropicamide on central corneal thickness and intraocular pressure

Abstract

Background: Dilating the eye with tropicamide may alter the intraocular pressure (IOP) because of an obstruction of the iridocorneal angle, resulting in decreased aqueous outflow drainage. Also, the repeated application of eyedrops and instrumentation could lead to increased central corneal thickness (CCT), consequently affecting IOP.

Aim: This study aimed to determine the effect of 1% tropicamide on CCT and IOP post-mydriasis among the University of Limpopo optometry students.

Setting: The data were collected at the optometry clinic of the University of Limpopo.

Methods: A within-subject experimental study was conducted on 59 healthy subjects aged 18 years – 28 years. A computer assisted simple random probability sampling was used to identify a sample of participants from the study population (N = 200). Baseline and post-mydriasis IOP (20 min, 30 min, and 45 min intervals) were measured with a Goldmann applanation tonometer. Central corneal thickness and IOP were analysed using means, correlations and paired t-tests.

Results: The mean CCT pre-mydriasis was 504.68 μm, and post-dilation was 507.90 μm, 510.08 μm and 509.25 μm at 20 min, 30 min, and 45 min, P = 026, p = 0.033, P = 0.004, respectively. Moreover, the mean IOP pre-mydriasis was 15.97 mmHg, and post-dilation was 16.85 mmHg, 16.46 mmHg and 16.85 mmHg over 20 min, 30 min, and 45 min of followed-up time, p = 0.140, p = 0.432, and p = 0.183, respectively.

Conclusion: Measuring IOP post-dilation is still valid; however, CCT should be measured before the instillation of tropicamide.

Contribution: This study analysed the effect of 1% tropicamide on CCT and IOP post-mydriasis in a clinical South African context.