Efficacy and Safety of Pilocarpine 1% on Presbyopia in Pseudophakic Patients
Mohsen Pourazizi1 *, Alireza Peyman1 , Maryam Naderi-Lordejani1 , Nima Koosha1
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract: Pilocarpine is a cholinergic muscarinic receptor agonist. Previous studies have indicated that pilocarpine can improve accommodation and depth of focus. However, this effect is negligible in pseudophakic patients with non-accommodative IOLs, on the other hand the pinhole effect caused by miotics can improve near visual acuity in these individuals. The aim of this study was to assess the efficacy and safety profile of pilocarpine 1% in improving near vision in monofocal pseudophakic patients.
Methods: This prospective, nonrandomized, open-label, pre-post interventional study enrolled patients who had a history of phacoemulsification and monofocal IOL implantation without any complications at least six months prior to intervention. One drop of 1% pilocarpine solution was instilled in patients’ eye and the near and distance visual acuity was investigated before and 20 minutes after the drop and up to 8 hours.
Results: Fifty-four eyes from 54 pseudophakic patients including 36 males (66.7%), with a mean age of 55.02 ±10.10 years were enrolled. Distance corrected Logarithm of the minimum angle of resolution (LogMAR) for near visual acuity improved significantly after 1% pilocarpine (P< 0.001). No significant decrease in LogMAR corrected distance visual acuity (CDVA) was observed after treatment (P= 0.60). Overall, 46 patients (85.2%) gained more than one line of near vision after treatment, and 8 patients (14.8%) didn’t show any improvement. Only 2 (3.7%) patients gained three lines in near vision. Headache, irritation, and nausea were observed in 3, 2 and 1 patients respectively.
Conclusion: The 1% pilocarpine solution demonstrated a statistically significant improvement in near visual acuity among pseudophakic patients, accompanied by an acceptable safety profile. Although this enhancement is notable, it may not be enough for total spectacle independence.
