Fast and stable mydriasis following intracameral injection of a combination of mydriatics and anaesthetic: real-life experience on patients undergoing cataract surgery

Session Details

Session Title: Moderated Poster Session: Cataract
Session Date/Time: Friday 09/02/2018 | 14:00-15:00
Paper Time: 14:08
Venue: Poster Area


First Author: D.Kęcik POLAND
Co Author(s): I. Grabska-Liberek  P. Jurowski  E. Mrukwa-Kominek  W. Omulecki  B. Romanowska-Dixon  J. Szaflik  

Abstract Details

Purpose:

Mydrane® (Laboratoires Théa, France), is the first ready to use combination of mydriatics and anaesthetic, approved in Europe that is injected into the anterior chamber at the beginning of cataract surgery to obtain mydriasis and intraocular anaesthesia. One 0.2-ml dose contains 0.04 mg of tropicamide, 0.62 mg of phenylephrine hydrochloride and 2 mg of lidocaine hydrochloride. We aimed to evaluate, in real life setting, the effect of Mydrane® on the pupil diameter at the four crucial points of cataract surgery and the effect of Mydrane® on time needed to obtain mydriasis and the stability of mydriasis.

Setting:

1 Departments of Ophthalmology, Medical University of Warsaw, 2 Department of Ophthalmology, Medical Centre for Postgraduate Education, Warsaw 3 Departments of Eye Diseases, Medical University of Lodz, 4 Department of Ophthalmology, Medical University of Silesia, Katowice 5 Department of Ophthalmology and Ocular Oncology, Jagiellonian University Medical College, Cracow,

Methods:

All patients admitted to seven departments for cataract surgery within a two-week period were asked to participate in the study. Patients whose pupils dilated to a diameter ≥6 mm after topical mydriatic administration during pre-operative examinations were scheduled to receive Mydrane® and were included in the registry. No additional inclusion criteria were used. Patient medical histories, examination results and operative details were recorded. Pupil diameter was measured: just before the start of surgery, just before capsulorhexis, just before intraocular lens implantation, and just before the end of surgery. Surgeons were asked to complete a Likert-based survey to collect their opinion.

Results:

A total of 307 patients were enrolled in the registry ( mean age 73.8±8.7 years). The mean pupil diameter was 7.0±1.0 mm before capsulorhexis and 6.9±1.2 mm before lens implementation. A pupil diameter ≥6 mm was achieved in 91.9% of patients just before capsulorhexis and 87.6% of patients just before lens implantation. We collected 307 questionnaires from the surgeons. We found that after 92.2% of surgeries surgeons agreed with the opinion “Mydriasis was obtained in a short time after the administration of Mydrane®”, while after 88.2% of surgeries surgeons agreed with the opinion “Mydriasis was stable after the administration of Mydrane®”.

Conclusions:

The mydriasis obtained after the injection of Mydrane® during cataract surgery was fast and stable, as demonstrated by pupil diameter measurements during surgery and surgeon feedback. Stable mydriasis may be achieved after single, intracameral administration of Mydrane® at the beginning of cataract surgery without preoperative dilatation, in a real-life patients’ population.

Financial Disclosure:

None