TY - JOUR
T1 - Adverse systemic effects from pledgets of topical ocular phenylephrine 10%
AU - Fraunfelder, Frederick W.
AU - Fraunfelder, Frederick T.
AU - Jensvold, Bree
N1 - Funding Information:
Supported in part by an unrestricted grant from Research to Prevent Blindness, New York, New York.
PY - 2002/10/1
Y1 - 2002/10/1
N2 - PURPOSE: To report 11 cases of adverse systemic reactions to topical ocular application of phenylephrine 10% in pledget form and to discourage this method of treatment for hemostasis in laser assisted in-situ keratomileusis (LASIK) surgery and other ophthalmic uses. DESIGN: Observational case series. METHODS: The literature, reports provided to the spontaneous reporting system of the United States Food and Drug Administration and the National Registry of Drug-Induced Ocular Side Effects (Casey Eye Institute, Portland, Oregon) were reviewed. Age, sex, duration of therapy, other drugs the patient was taking, and systemic reactions are provided in the series of 11 cases with adverse systemic reactions. RESULTS: Eleven cases of adverse systemic reactions to topical ocular phenylephrine 10% applied in pledget form occurred in 8 male and 3 female patients with an age range from 1 to 76 years. All cases occurred after a single exposure, most patients noted systemic effects within minutes of phenylephrine application, and the adverse systemic reactions included severe hypertension, pulmonary edema, cardiac arrhythmia, cardiac arrest, and subarachnoid hemorrhage. CONCLUSIONS: We recommend ophthalmologists not use this method of phenylephrine application and believe it is contraindicated in ophthalmic surgery, especially when other medications may be used.
AB - PURPOSE: To report 11 cases of adverse systemic reactions to topical ocular application of phenylephrine 10% in pledget form and to discourage this method of treatment for hemostasis in laser assisted in-situ keratomileusis (LASIK) surgery and other ophthalmic uses. DESIGN: Observational case series. METHODS: The literature, reports provided to the spontaneous reporting system of the United States Food and Drug Administration and the National Registry of Drug-Induced Ocular Side Effects (Casey Eye Institute, Portland, Oregon) were reviewed. Age, sex, duration of therapy, other drugs the patient was taking, and systemic reactions are provided in the series of 11 cases with adverse systemic reactions. RESULTS: Eleven cases of adverse systemic reactions to topical ocular phenylephrine 10% applied in pledget form occurred in 8 male and 3 female patients with an age range from 1 to 76 years. All cases occurred after a single exposure, most patients noted systemic effects within minutes of phenylephrine application, and the adverse systemic reactions included severe hypertension, pulmonary edema, cardiac arrhythmia, cardiac arrest, and subarachnoid hemorrhage. CONCLUSIONS: We recommend ophthalmologists not use this method of phenylephrine application and believe it is contraindicated in ophthalmic surgery, especially when other medications may be used.
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U2 - 10.1016/S0002-9394(02)01591-X
DO - 10.1016/S0002-9394(02)01591-X
M3 - Article
C2 - 12383833
AN - SCOPUS:0036808573
SN - 0002-9394
VL - 134
SP - 624
EP - 625
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 4
ER -