Despite the various advantages of femtosecond
laser-assisted
cataract surgery (FLACS), pupillary constriction during
laser photodisruption is considered one of the most unfavorable events. This study aimed to investigate the efficacy of intracameral 0.015%
epinephrine injection for
miosis after
laser pretreatment during FLACS.A total of 82 patients who underwent FLACS for age-related
cataracts were investigated in this retrospective study. The
epinephrine group included patients who received intracameral
epinephrine injection for
miosis after femtosecond
laser pretreatment, while the no-
epinephrine group included the patients who underwent FLACS without intracameral
epinephrine due to minimal
miosis. Quantitative pupil area measurements were performed through the analysis of captured images extracted from surgical videos of both femtosecond
laser pretreatment and
phacoemulsification.Laser photodisruption induced
miosis in both groups, although the degree of
miosis was greater in the
epinephrine group (4.65 ± 0.87 mm) than in the no-
epinephrine group (6.30 ± 0.65 mm; P < .001). The intracameral
epinephrine injection significantly increased the pupil diameter from 4.65 ± 0.87 to 5.49 ± 0.76 mm (21.61 ± 22.68%; P < .001) and the pupil area from 70.28 ± 24.46 to 96.49 ± 25.24 mm (52.89 ± 63.54%; P < .001). After additional viscomydriasis, there was no difference between groups in pupil diameter (
epinephrine vs no-
epinephrine group; 6.10 ± 0.77 vs 6.39 ± 0.65 mm; P = .073).A single
intracameral injection of 0.015%
epinephrine provided immediate and appropriate redilation of pupil in patients with significant
miosis after femtosecond
laser photodisruption. Intracameral
epinephrine is a simple and practical option for pupil redilation in case of
miosis during FLACS.