Individual and Additive Mydriatic Effect of Tropicamide with Phenylephrine and Flurbiprofen in Diabetic Patients

Diabetes mellitus is a chronic metabolic disorder and one of its major complications is diabetic retinopathy. For ophthalmological screening of diabetic retinopathy, we use mydriatic drugs for pupil dilation. As per the literature review, there is no clinical data available in Indian population for the combination of Tropicamide and Flurbiprofen. Hence, the present study was carried out in an attempt to study the possible mydriatic effect of selected combination in diabetic patients. A randomized controlled trial was conducted in diabetic patients. Patients were divided into three groups and a sample size of fifty was included by calculation in each group. Tropicamide was instilled in all the groups, Phenylephrine and Flurbiprofen was instilled in groups 2 and 3 respectively. The mean pupil dilation using Tropicamide and Flurbiprofen combination was higher (P<0.01) compared with Tropicamide alone and in combination with Phenylephrine. A new combination of Tropicamide (muscarinic receptor antagonist) and Flurbiprofen (non-steroidal and anti-inflammatory drug) was found to be more effective in bringing maximal dilation of pupil in diabetic patients. Further studies with different combinations and concentrations may be carried out.