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Purpose: To evaluate and compare in a masked fashion the influence of using two different concentrations of carbachol drops on the outcome of presbyopia treatment. Methods: A prospective, double-masked, randomized study. 57 emmetropic and presbyopic subjects aged between 44 and 60 years with an uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion. Subjects were divided into 2 groups. Group 1 (n=32 eyes) received single dose of 2.25% carbachol plus 0.2% brimonidine eye drops. Group 2 (n=25) received single dose of 3% carbachol plus 0.2% brimonidine eye drops. The subjects’ pupil size and both near and distance visual acuities were evaluated before and after treatment at 1, 2, 4, 8 and 12 hr, by a masked examiner at the same room illumination. Results: Statistically significant improvement in mean near visual acuity (NVA) was achieved in all subjects who received both concentrations of carbachol plus brimonidine drops (P < 0.0001). Significant and sustained improvement in mean NVA was reported in higher concentrations of carbachol drops than in lower concentrations (P < 0.0001). No serious adverse ocular effects were observed in any of the subjects of both groups. Conclusion: Based on the data, higher concentration of carbachol was found to be safe and provided greater efficacy in improving near visual acuity than lower concentration with prolonged duration of action.

Influence of Different Concentrations of Carbachol Drops on the Outcome of Presbyopia Treatment – A Randomized Study