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A paired comparison of intracameral mydriatics in refractive lens exchange surgery.

AbstractPURPOSE:
To compare the efficacy and intra-operative safety of intracameral mydriatics to topical mydriatics in patients undergoing refractive lens exchange (RLE) surgery.
METHODS:
In a randomized intra-individually comparing study performed at Koskelas Eye Clinic, Luleå, and Department of Clinical Sciences/Ophthalmology, Umeå University Hospital, Umeå, Sweden, 56 patients undergoing same-day bilateral RLE were included. Pupils were randomly dilated with topical mydriatics in one eye and intracameral mydriatics in the fellow eye. Pupil sizes were recorded intra-operatively throughout the procedures. Perceived pain/discomfort and glare were assessed immediately postoperatively using a visual analogue scale from 0 to 10.
RESULTS:
Topical mydriatics and intracameral mydriatics both give satisfactory pupil dilation in routine RLE. However, there was noticeable iris billowing in 17 eyes dilated with topical mydriatics but only one eye with intracameral mydriatics (p < 0.001). Pupils were initially slightly larger in the topical mydriatics group but contracted during surgery. There was no perceived difference with regards to glare, pain or discomfort between the treatments. The surgeon graded intracameral mydriatics eyes as easier to operate on.
CONCLUSION:
Both topical mydriatics and intracameral mydriatics give satisfactory mydriasis for RLE, but pupil constriction and iris billowing are more pronounced with topical mydriatics.
AuthorsOskar Lundqvist, Timo Koskela, Anders Behndig
JournalActa ophthalmologica (Acta Ophthalmol) Vol. 92 Issue 5 Pg. 482-5 (Aug 2014) ISSN: 1755-3768 [Electronic] England
PMID23981528 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Copyright© 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Chemical References
  • Drug Combinations
  • Mydriatics
  • Ophthalmic Solutions
  • phenylephrine, lidocaine drug combination
  • Phenylephrine
  • Lidocaine
  • Cyclopentolate
Topics
  • Administration, Topical
  • Anterior Chamber (drug effects)
  • Cyclopentolate (administration & dosage)
  • Drug Combinations
  • Eye Pain (diagnosis)
  • Female
  • Glare
  • Humans
  • Iris (drug effects, physiopathology)
  • Lens Implantation, Intraocular
  • Lidocaine (administration & dosage)
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Mydriatics (administration & dosage)
  • Ophthalmic Solutions
  • Phacoemulsification
  • Phenylephrine (administration & dosage)
  • Prospective Studies
  • Pupil (drug effects, physiology)

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