Posters

Pupil diameter during cataract surgery after intracameral injection of the first ready-to-use combination of mydriatics and anaesthetic injected at the beginning of surgery in patients with pupil < 6 mm during the preoperative assessment

Poster Details

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:

Thus far, in Poland, topical mydriatic eye drops have served as the standard method for achieving pupil dilatation before cataract surgery. In 2015, the first ready-to-use, standardised product, Mydrane® (Laboratoires Théa, France) was approved for use in several European countries, including Poland. The product is injected into the anterior chamber at the beginning of cataract surgery to induce mydriasis and intraocular anaesthesia. We aimed to evaluate, in real life setting, the effect of Mydrane® on the pupil diameter during cataract surgery in the population of patients with pupil < 6 mm after use of topical mydriatics during the preoperative assessment.

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:

According to the Summary of Product Characteristics “Mydrane should only be used in patients who have demonstrated, at a previous visit, a satisfactory pupil dilation with topical mydriatic therapy” but the cut-off point for “satisfactory pupil dilatation with topical therapy” is not unambiguously defined. We collected and analysed the data of the 59 consecutive patients operated in seven departments during two weeks in March 2017, whose pupils were dilated to a diameter <6 mm after the administration of eye drops during the pre-operative visit and who received Mydrane® at the beginning of cataract surgery to obtain mydriasis and intraocular anaesthesia.

Results:

In the group of 59 patients with pupil < 6 mm after topical mydriatics during preoperative assessment in 36 cases (61.0%) cataract surgery was performed using only Mydrane®, without the use of any additional drugs or medical devices to obtain mydriasis. The mean pupil diameter in this group (36 out of 59) during the preoperative assessment, after topical mydriatics was 5.1±0.74 mm and 6.15±1.14 mm just before capsulorhexis when Mydrane® was injected during surgery. Additional drugs were used in 23 cases (39%). In this group mean pupil diameter after topical mydriasis was 4.58±1.06 mm and 5.6±1.26 mm respectively.

Conclusions:

In real life setting mean pupil diameter achieved during cataract surgery after intracameral injection of Mydrane®, injected at the beginning of surgery, in patients with pupil < 6 mm during the preoperative assessment, was over 1mm larger than mean pupil diameter after topical mydriatics, despite the trauma caused by the operation. Our study showed that the first ready to use a combination of mydriatics and anaesthetic (Mydrane®) allows achieving sufficient mydriasis during surgery also in the population of patients with pupil < 6mm during the preoperative assessment, what is important from the clinical and organisational point of view.

Financial Disclosure:

None