Comparison of cyclopentolate versus tropicamide cycloplegia: A systematic review and meta-analysis
Bibliographic record
Abstract
Purpose The aim of the present meta-analysis is to compare the efficacy of cyclopentolate and tropicamide in controlling accommodation during refraction. Methods A comprehensive literature search was performed in PubMed, Scopus, Science direct and Ovid databases by the key words: “tropicamide”; “cyclopentolate”; “cycloplegia” and “cycloplegic” from inception to April 2016. Methodological quality of the literature was evaluated according to the Oxford Center for Evidence Based Medicine and modified Newcastle-Ottawa scale. Statistical analyses were performed using Comprehensive Meta-Analysis (version 2; Biostat Inc., USA). Results The present meta-analysis included six studies (three randomized controlled trials and three case–control studies). Pooled standardized difference in the mean changes in the refractive error was 0.175 D [lower and upper limits: −0.089; 0.438] more plus in the cyclopentolate group compared to the tropicamide group; however, this difference was not statistically significant ( p = 0.194; Cochrane Q value = 171.72 ( p < 0.05); I 2 = 95.34%). Egger's regression intercept was −5.33 ( p = 0.170). Considering type of refractive errors; refractive assessment procedure and age group; although cycloplegic effect of cyclopentolate was stronger than tropicamide; however, this effect was only statistically significant in children; hyperopic patients and with retinoscopy. Conclusion We suggest that tropicamide may be considered as a viable substitute for cyclopentolate due to its rapid onset of action. Although these results should be used cautiously in infants and in patients with high hyperopia or strabismus when using tropicamide as the sole cycloplegic agent especially in situations that the findings are variable or there is no consistency between the examination results and clinical manifestations of the visual problems.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.023 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.021 | 0.042 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".