Advere ytemic effect from pledget of topical ocular phenylephrine 10%

PURPOE: To report 11 cae of advere ytemic reaction to topical ocular application of phenylephrine 10% in pledget form and to dicourage thi method of treatment for hemotai in laer aited in-itu keratomileui (LAIK) urgery and other ophthalmic ue. DEIGN: Obervational cae erie. METHOD: The literature, report provided to the pontaneou reporting ytem of the United tate Food and Drug Adminitration and the National Regitry of Drug-Induced Ocular ide Effect (Caey Eye Intitute, Portland, Oregon) were reviewed. Age, ex, duration of therapy, other drug the patient wa taking, and ytemic reaction are provided in the erie of 11 cae with advere ytemic reaction. REULT: Eleven cae of advere ytemic reaction to topical ocular phenylephrine 10% applied in pledget form occurred in 8 male and 3 female patient with an age range from 1 to 76 year. All cae occurred after a ingle expoure, mot patient noted ytemic effect within minute of phenylephrine application, and the advere ytemic reaction included evere hypertenion, pulmonary edema, cardiac arrhythmia, cardiac arret, and ubarachnoid hemorrhage. CONCLUION: We recommend ophthalmologit not ue thi method of phenylephrine application and believe it i contraindicated in ophthalmic urgery, epecially when other medication may be ued.