Pupil dilation using a standard cataract surgery regimen alone or with atropine 1.0% pretreatment: prospective comparative evaluation

J Cataract Refract Surg. 2010 Apr;36(4):563-7. doi: 10.1016/j.jcrs.2009.10.049.


Purpose: To compare the amount of pupil dilation produced by a set of commonly used preoperative mydriatic agents for cataract surgery, with the same regimen preceded by topical administration of atropine 1.0%.

Setting: Department of Ophthalmology, Loma Linda University, Loma Linda, California, USA.

Methods: In this prospective unmasked study, the baseline pupil size in eyes of volunteers was measured. Pupil size was then measured 30 minutes after instillation of the institution's standard dilation regimen for cataract surgery, which included phenylephrine 2.5%, tropicamide 1.0%, and cyclopentolate 1.0%. Several days later, the subjects returned for repeat measurements after pretreating the study eye(s) with atropine 1.0% 3 times a day the day previously and once on the morning of repeat dilation and measurements. Pupil size was again measured after administration of the standard regimen.

Results: The study included 72 eyes of 54 patients. A paired t test showed a statistically significant difference in mean pupil dilation between the standard regimen alone and the standard regimen with atropine 1.0% pretreatment. The mean pupil dilation was 7.3 mm +/- 1.2 (SD) with the standard regimen alone and 6.9 +/- 1.2 mm with the standard regimen with atropine pretreatment; the difference was statistically significant (P<.001).

Conclusion: The addition of atropine 1.0% 1 day before administration of a standard preoperative dilating regimen for cataract surgery resulted in a smaller dilated pupil diameter than administration of the standard set of preoperative mydriatic agents alone.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Atropine / administration & dosage*
  • Cataract Extraction*
  • Cyclopentolate / administration & dosage
  • Diagnostic Techniques, Ophthalmological
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mydriatics / administration & dosage*
  • Phenylephrine / administration & dosage
  • Prospective Studies
  • Pupil / drug effects*
  • Pupil / physiology
  • Self Administration
  • Tropicamide / administration & dosage
  • Young Adult


  • Mydriatics
  • Phenylephrine
  • Atropine
  • Cyclopentolate
  • Tropicamide