Details
MezaNext Indications
The drug MezaNext is used to dilate the pupil during diagnostic and / or therapeutic procedures; in uveitis - in order to rupture the posterior synechiae or to prevent their occurrence; during surgery; to study refraction without cycloplegia; during fundus examinations and other diagnostic procedures.
Contradictions
· Hypersensitivity to any component of the drug.
· Significant disorders of the cardiovascular system (heart disease, hypertension, aneurysm, tachycardia), especially in elderly patients.
· Thyrotoxicosis.
· Insulin-dependent diabetes mellitus.
· Hyperthyroidism.
· Concomitant use of monoamine oxidase inhibitors (MAOIs) and for 2 weeks after stopping treatment with MAOIs.
· Concomitant use with tricyclic antidepressants, antihypertensive drugs (including β-blockers).
· Congenital deficiency of glucose-6-phosphate dehydrogenase.
· Hepatic porphyria.
· Angular glaucoma (except in cases of previous iridectomy) and patients with a narrow anterior chamber angle, who have an increased susceptibility to glaucoma with the use of mydriatic drugs.
· Use in preterm and low birth weight infants.
· Use in newborns and infants with cardiovascular or cerebrovascular disorders.
· Use in elderly patients with severe atherosclerotic, cardiovascular or cerebrovascular diseases.
· Additional dilation of the pupil during surgery in patients with impaired integrity of the eyeball or with impaired tear function.
Dosage & Administration
Vasoconstriction and dilation of the pupil
1 drop of solution is instilled into the affected eye (s).
If necessary, the dose can be repeated only once, at least an hour after the first instillation.
To avoid local irritation and further thinning of the tear fluid, it is recommended to use a local anesthetic a few minutes before instillation of MezaNext.
The use of MezaNext is especially acceptable when it is necessary to eliminate the stagnation of conjunctival blood vessels, rapid and powerful dilation of the pupil without cycloplegia.
Uveiti and posterior synechiae
Used to prevent or in the formation of synechiae. Their formation can be prevented by severe dilation of the pupil with phenylephrine, atropine or other cycloplegic agents.
In the sore eye instilled 1 drop of solution 1-2 times a day. The maximum dose should not exceed 3 drops per day. If necessary, treatment can be repeated the next day.
If this treatment brings positive results, warm compresses and atropine can be included in the treatment regimen.
Glaucoma
In patients with open-angle glaucoma, MezaNext can be used concomitantly with miotics, as phenylephrine enhances their hypotensive effect and reduces their side effect on visual acuity, as it expands the narrowed visual field.
1 drop of solution is instilled into the affected eye (s).
Surgical interventions
The drug is used in cases where it is necessary to achieve a strong short-term dilation of the pupils. Instill 1 drop in the affected eye / eyes 30 - 60 minutes before surgery.
Refraction
Phenylephrine enhances the mydriatic action of homatropin, cyclopentolate, tropicamide, atropine.
1 drop of solution is instilled into the affected eye (s).
Ophthalmoscopy
In 15 - 30 min after instillation of 1 drop of solution the adequate mydriasis lasting 1 - 3 hours is provided.
Provocative test for angle-closure glaucoma
The drug MezaNext is used to diagnose chronic glaucoma. Before and after pupil dilation, which causes phenylephrine, it is necessary to measure intraocular pressure and perform gonioscopy.
A significant increase in intraocular pressure in combination with a narrow angle of the anterior chamber, established by gonioscopy, gives reason to suspect the presence of glaucoma. It should be noted that a negative test result does not preclude its presence.
Retinoscopy
Used in cases where dilation of the pupils without cycloplegia is required.
In any of the procedures described above, irises with more intense pigmentation require the use of higher doses of phenylephrine.
Diagnostic test for leaching
Two drops of the solution are injected into the hyperemic eye, perilimbal hyperemia can be observed within 5 min after instillation. Fading is characteristic of the conjunctiva, superficial hyperemia is more characteristic of conjunctivitis than iridocyclitis.
Elderly patients (over 65 years)
No dose adjustment is required in this group of patients. In most cases, repeated instillations may give less pronounced mydriasis. Usually one drop of phenylephrine is administered 5 minutes after the selected cycloplegic agent.
Application method
The drops are instilled into the conjunctival sac, and to avoid absorption of the drug through the nasal mucosa and increase local action, in particular in infants, children and the elderly, the nasolacrimal duct should be pressed with a finger for 2-3 minutes or close the eyes for 3 minutes after instillation .
When instilling the drops into the affected eye / eyes, do not touch the tip of the eyelid dropper, the skin around the eyes or other surfaces to avoid contamination.
Children.
In pediatric practice, the drug can be used for diagnostic procedures (ophthalmoscopy, retinography) for children from the first days of life. Use in preterm infants is possible with caution after evaluation by a physician of the benefit / risk ratio, not more than 1 drop in each eye.