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Jeffrey Golen, Timothy Saunders, Nicholas Sprehe, Patrick Gore, Sharad Malavade, Peter Pavan, Curtis Margo, Lions Eye Institute for Transplant & Research; Can Meaningful Pharmacological Dilation of Pupils Occur After Death?. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2319.
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To explore the effectiveness of topical mydriatic agents on pupil dilation on eyes obtained postmortem.
A review of pre-death records is conducted to include demographics, medical history, ocular history and medications if available. Eyes obtained after death are inspected for iris color and signs of abnormalities. Exclusion criteria include history of surgical iris, prior history of iris trauma, iris melanoma, iritis, or iridoschisis. The status of the lens is recorded. After a baseline pupil diameter measurement, two drops of a solution of 10% phelylephrine and 1% tropicamide is placed on the surface of the cornea. The set of drops is repeated twice, 3 minutes apart. Pupils are then measured 20 and 60 minutes later with a millimeter ruler and recorded on a digital camera for post-hoc analysis.
Effective pupillary dilation was achieved up to 19 hours after death (Figures 1a, 1b). Pupil dilation up to 2.9mm was measured and occurred in a heterogeneous group of unfixed tissue bank eyes. The results are seen across a range of iris colors. The results were also seen in eyes both pre and post tissue procurement.
Pharmacological dilation of pupils is possible after death in fresh eyes harvested through eye banks. Knowledge of this phenomenon and characteristics associated with a favorable response is useful for screening postmortem eyes for specific research interests. Further research is needed to find out which combination of medications is the most effective for this purpose.
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