Evaluation of Pilocarpine Eye Drops at Various Concentrations for Presbyopia Management: A Comparative Study and A Brief Review of Treatment Options "
Mohammad javad Vahidi fard1 *, Shahram Bamdad1 , Alireza attar1
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract: This study evaluated the efficacy and safety of pilocarpine eye drops at 1%, 1.25%, and 1.5% concentrations for managing presbyopia. Key outcomes included uncorrected near visual acuity (UNVA), near point of accommodation (NPA), intraocular pressure (IOP), and contrast sensitivity.
Methods: A randomized, double-masked trial involved 200 participants (aged 40+) divided into four groups: pilocarpine 1%, 1.25%, 1.5%, and a control. Drops were administered twice daily for 30 days. Visual acuity was assessed with a Snellen near chart, and secondary measures included NPA (cm), IOP (mmHg), and contrast sensitivity (%). Data were analyzed using ANCOVA and repeated measures analysis.
Results: Significant improvements in near visual acuity were observed in all pilocarpine groups, with 1.5% showing the largest gains (p<0.001p < 0.001p<0.001). NPA improved substantially across all treatment groups. IOP was notably reduced in the 1% group, while higher concentrations showed stable IOP. Contrast sensitivity also improved significantly in all pilocarpine-treated groups compared to control.
Conclusion: Pilocarpine, especially at 1.5%, proved effective for presbyopia management, enhancing UNVA and contrast sensitivity without significant IOP elevation. These findings suggest pilocarpine is a promising pharmacological alternative for non-invasive presbyopia correction. Further research is needed to optimize long-term use and evaluate broader applicability.
