Intracameral mydriasis vs eyedrop mydriasis in phacoemulsification

Session Details

Session Title: Cataract Surgery Instrumentation/Surgical Devices

Session Date/Time: Sunday 11/09/2016 | 10:30-12:00

Paper Time: 10:36

Venue: Hall C1

First Author: : A.Panico ITALY

Co Author(s): :    R. Bellucci                    

Abstract Details

Purpose:

A new drug to be injected into the anterior chamber to obtain intra-ocular mydriasis has become available, composed of 0.2 mg/ml tropicamide, 3.1 mg/ml phenylephrine, and 10 mg/ml lidocaine. When injected before cataract surgery, there might be no need for pre-operative topical mydriatic drops. This study investigated the mydriasis obtained as compared with eyedrop pre-operative pupil dilation.

Setting:

Hospital San Bonifacio, Verona, Italy

Methods:

Twenty unselected consecutive patients received 0.3 ml of the new drug within the anterior chamber after the first corneal incision. After 30 seconds, 1% sodium hyaluronate was injected to fill the anterior chamber. The level of mydriasis was measured with caliper before capsulorhexis and before IOL implantation. A control group of 20 unselected patients received the standard pre-operative mydriatic drops: 0.5% tropicamide plus 10% phenylephrine at times -45min, -30 min, -15 min before surgery. Epinephrine 1:1M was added to the irrigating BSS in both groups. Endothelial cell count was performed before surgery and 1 month after surgery.

Results:

There were no differences in age (836y vs. 845y), in the number of pseudoexfoliation (0 in each group), and in expected floppy iris (0 per group). Before capsulorhexis, the pupil diameter was 6.830.66mm in the intraocular mydriasis eyes, and was 7.820.76mm (P<0.001). Before IOL implantation, the pupil diameter was 7.060.64mm and 7.510.79mm respectively (P=0.06). At surgery some iris atony was observed in 4 eyes with the intracameral mydriasis, and in 1 eye with the eyedrop mydriasis. No intra-operative complication was recorded in either group. No relevant difference in the endothelial cell loss was noted between groups.

Conclusions:

With the new drug designed for intracameral use, the obtained mydriasis was lower than with pre-operative mydriatic eyedrops, however with no consequences on the feasibility of cataract surgery. This difference faded at the end of surgery with epinephrine added to the BSS. Taking into account the saving of nursing time, the new drug can be considered as an alternative to eye drop mydriasis.

Financial Disclosure:

NONE