A novel pharmacological treatment of pseudophakic presbyopia

Almamoun Abdelkader


AIM: To assess the effectiveness of combining an alpha agonist(brimonidine) with parasympathomimetic drops (carbachol) toinduce therapeutic miosis with the goal of reducing the impact ofpresbyopia in people who are pseudophakic. METHODS: A randomly allocated, double-masked, placebocontrolled, prospective clinical investigation. Included were fortyemmetropic and presbyopic pseudo-phakes, aged 30 to 80, who haduncorrected distance visual acuity of at least 20/20 in each of theireyes and no other optic abnormalities. There were a couple of setsof subjects. In the non-dominant eyes of the intervention group (n =25 eyes), one dosage of 3% carbachol mixed with 0.2% brimonidine eye drops was applied. 15 eyes made up the controlgroup got placebo drops. The exact impartial evaluator measuredthe initial pupil size and the subjects' close and far visual acuitiesprior to treatment, as well as at one, two, four, and eight hours posttreatment in the identical lighting conditions. RESULTS: When carbachol with brimonidine drops were given topseudophakic individuals, all showed significant improvements innear vision (p < 0.0001). Not a single individual preferred theplacebo, and all were enthusiastic with the drops. CONCLUSIONS: Making the pupil small creates a pinhole cameralike effect which safely improves near visual acuity in pseudophakicpresbyopes via increased depth of focus.

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