Intracameral mydriatics versus topical mydriatics in pupil dilation for phacoemulsification cataract surgery

Amelia Lim Lay Suan, Jemaima Che Hamzah, Tan Soo Ken, Vanessa Naseem Mansurali

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose To evaluate the efficacy and safety of intracameral mydriatics (lidocaine 1.0% and phenylephrine 1.5%) versus topical mydriatics (phenylephrine 2.5% and tropicamide 1.0%) in pupil dilation for phacoemulsification surgery in Malaysians. Setting Department of Ophthalmology, Penang General Hospital, Georgetown Penang, Malaysia. Design Prospective comparative case series. Method Patients with immature cataract were randomized to the topical mydriatic group (topical group) or intracameral mydriatic group (intracameral group). Patients with small pupils and complicated cataracts were excluded. Pupil diameter changes were measured throughout the surgery. Additional pupil dilation maneuvers and complications were recorded. Results The study comprised 112 patients. There was no difference in mean pupil dilation between the intracameral group (4.86 mm ± 0.74 [SD]) and the topical group (4.88 ± 0.91 mm) (P =.86). However, the mean pupil size before capsulorhexis in the topical group (7.23 ± 1.08 mm) was significantly larger than in the intracameral group (6.40 ± 0.80 mm) (P =.01). The pupils in the intracameral group continued to dilate during surgery (0.44 ± 0.62 mm), while those in the topical group constricted (−0.41 ± 1.04 mm) (P <.001). Three patients in the intracameral group and 6 in the topical group required additional maneuvers for pupil dilation (P =.49). Each group had 1 complication (P = 1.00). Conclusions Intracameral mydriatic agents dilated heavily pigmented pupils for phacoemulsification cataract surgery. However, in the early stages of surgery, pupil dilation was slower than with topical agents.

Original languageEnglish
Pages (from-to)1031-1035
Number of pages5
JournalJournal of Cataract and Refractive Surgery
Volume43
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017

Fingerprint

Mydriatics
Pupil
Cataract
Dilatation
Phacoemulsification
Tropicamide
Capsulorhexis
Miosis
Malaysia
Phenylephrine
Ophthalmology
General Hospitals
Safety

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology
  • Sensory Systems

Cite this

Intracameral mydriatics versus topical mydriatics in pupil dilation for phacoemulsification cataract surgery. / Lay Suan, Amelia Lim; Che Hamzah, Jemaima; Ken, Tan Soo; Mansurali, Vanessa Naseem.

In: Journal of Cataract and Refractive Surgery, Vol. 43, No. 8, 01.08.2017, p. 1031-1035.

Research output: Contribution to journalArticle

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abstract = "Purpose To evaluate the efficacy and safety of intracameral mydriatics (lidocaine 1.0{\%} and phenylephrine 1.5{\%}) versus topical mydriatics (phenylephrine 2.5{\%} and tropicamide 1.0{\%}) in pupil dilation for phacoemulsification surgery in Malaysians. Setting Department of Ophthalmology, Penang General Hospital, Georgetown Penang, Malaysia. Design Prospective comparative case series. Method Patients with immature cataract were randomized to the topical mydriatic group (topical group) or intracameral mydriatic group (intracameral group). Patients with small pupils and complicated cataracts were excluded. Pupil diameter changes were measured throughout the surgery. Additional pupil dilation maneuvers and complications were recorded. Results The study comprised 112 patients. There was no difference in mean pupil dilation between the intracameral group (4.86 mm ± 0.74 [SD]) and the topical group (4.88 ± 0.91 mm) (P =.86). However, the mean pupil size before capsulorhexis in the topical group (7.23 ± 1.08 mm) was significantly larger than in the intracameral group (6.40 ± 0.80 mm) (P =.01). The pupils in the intracameral group continued to dilate during surgery (0.44 ± 0.62 mm), while those in the topical group constricted (−0.41 ± 1.04 mm) (P <.001). Three patients in the intracameral group and 6 in the topical group required additional maneuvers for pupil dilation (P =.49). Each group had 1 complication (P = 1.00). Conclusions Intracameral mydriatic agents dilated heavily pigmented pupils for phacoemulsification cataract surgery. However, in the early stages of surgery, pupil dilation was slower than with topical agents.",
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N2 - Purpose To evaluate the efficacy and safety of intracameral mydriatics (lidocaine 1.0% and phenylephrine 1.5%) versus topical mydriatics (phenylephrine 2.5% and tropicamide 1.0%) in pupil dilation for phacoemulsification surgery in Malaysians. Setting Department of Ophthalmology, Penang General Hospital, Georgetown Penang, Malaysia. Design Prospective comparative case series. Method Patients with immature cataract were randomized to the topical mydriatic group (topical group) or intracameral mydriatic group (intracameral group). Patients with small pupils and complicated cataracts were excluded. Pupil diameter changes were measured throughout the surgery. Additional pupil dilation maneuvers and complications were recorded. Results The study comprised 112 patients. There was no difference in mean pupil dilation between the intracameral group (4.86 mm ± 0.74 [SD]) and the topical group (4.88 ± 0.91 mm) (P =.86). However, the mean pupil size before capsulorhexis in the topical group (7.23 ± 1.08 mm) was significantly larger than in the intracameral group (6.40 ± 0.80 mm) (P =.01). The pupils in the intracameral group continued to dilate during surgery (0.44 ± 0.62 mm), while those in the topical group constricted (−0.41 ± 1.04 mm) (P <.001). Three patients in the intracameral group and 6 in the topical group required additional maneuvers for pupil dilation (P =.49). Each group had 1 complication (P = 1.00). Conclusions Intracameral mydriatic agents dilated heavily pigmented pupils for phacoemulsification cataract surgery. However, in the early stages of surgery, pupil dilation was slower than with topical agents.

AB - Purpose To evaluate the efficacy and safety of intracameral mydriatics (lidocaine 1.0% and phenylephrine 1.5%) versus topical mydriatics (phenylephrine 2.5% and tropicamide 1.0%) in pupil dilation for phacoemulsification surgery in Malaysians. Setting Department of Ophthalmology, Penang General Hospital, Georgetown Penang, Malaysia. Design Prospective comparative case series. Method Patients with immature cataract were randomized to the topical mydriatic group (topical group) or intracameral mydriatic group (intracameral group). Patients with small pupils and complicated cataracts were excluded. Pupil diameter changes were measured throughout the surgery. Additional pupil dilation maneuvers and complications were recorded. Results The study comprised 112 patients. There was no difference in mean pupil dilation between the intracameral group (4.86 mm ± 0.74 [SD]) and the topical group (4.88 ± 0.91 mm) (P =.86). However, the mean pupil size before capsulorhexis in the topical group (7.23 ± 1.08 mm) was significantly larger than in the intracameral group (6.40 ± 0.80 mm) (P =.01). The pupils in the intracameral group continued to dilate during surgery (0.44 ± 0.62 mm), while those in the topical group constricted (−0.41 ± 1.04 mm) (P <.001). Three patients in the intracameral group and 6 in the topical group required additional maneuvers for pupil dilation (P =.49). Each group had 1 complication (P = 1.00). Conclusions Intracameral mydriatic agents dilated heavily pigmented pupils for phacoemulsification cataract surgery. However, in the early stages of surgery, pupil dilation was slower than with topical agents.

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