Financial Disclosure Drs. Nix and Awdeh have no financial relationships to disclose. Dr. Yoo has received consultant, research, and travel reimbursement.

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Presentation transcript:

Financial Disclosure Drs. Nix and Awdeh have no financial relationships to disclose. Dr. Yoo has received consultant, research, and travel reimbursement from Alcon, Carl Zeiss Meditec, and IntraLase. The authors of this poster have no financial interest in the subject matter of this poster.

Pupil Dilation During Phacoemulsification Surgery: Comparison of Topical Anesthetics and Mydriatics Versus Intracameral “Epi-Shugarcaine” Cynthia P. Nix, M.D. Richard M. Awdeh, M.D. Sonio H. Yoo, M.D. Bascom Palmer Eye Institute

Purpose To evaluate the efficacy of intracameral “epi-Shugarcaine” in the absence of preoperative drops on pupil dilation for phacoemulsification cataract extraction surgery

Methods A prospective, comparative study of 18 eyes of 18 patients undergoing phacoemulsification cataract extraction surgery by a single surgeon at the Bascom Palmer Eye Institute Patients on systemic alpha-blockers were excluded.

Methods Group A (9 eyes): Group B (9 eyes): Pre-operative gtts 3 cycles q 15 minutes prior to surgery phenylephrine 2.5% cyclopentolate 1% scopoloamine 0.25% flurbiprofen 0.03% Group B (9 eyes): Intraoperative intracameral injection of “epi-Shugarcaine”

Methods Vertical Pupil Diameter was measured with surgical calipers At the start of the case after topical dilating drops (Group A) Following the injection of “epi-Shugarcaine” (Group B) And, following the injection of viscoelastic (all eyes) Time to dilation, iris stability, and surgical complications were recorded.

Results The mean age, sex, cataract density, and baseline photopic pupil size were comparable between the topical and intracameral groups.

Results Pupil Dilation (mm) Group A (n=9) Group B P value Topical gtts 8.0 ± 0.5 - Epi-Shugarcaine 5.4 ± 1.3 <0.0001 Viscoelastic 6.1 ± 1.2

Results Iris stability was comparable between the groups. Group B had more intraoperative complications (though not statistically significant due to small study size). There was a subjective difference in surgical performance between the groups Group B was mildly more difficult due to smaller pupil diameters

Conclusions “Epi-Shugarcaine” provided rapid and effective mydriasis in eyes that did not receive topical mydriatric drops prior to cataract surgery. However, pupil dilation was significantly greater in eyes receiving traditional topical mydriatics.

References Lundberg B, Behnidig A. Separate and additive mydriatic effects of lidocaine hydrochloride, phenylephrine, and cyclopentolate after intracameral injection. J Cataract Refract Surg. 2008 Feb;34(2):280-3. Nikeghbali A, et al. Pupil dilation with intracameral lidocaine during phacoemulsification: Benefits for the patient and surgeon. Indian J Ophthalmol. 2008 Jan-Feb;56(1):63-4. Nogoei E. Cataract Surgery: To omit or not to omit? ASCRS EyeWorld 2007. Nikeghbali A, et al. Pupil dilation with intracameral lidocaine during phacoemulsification. J Cataract Refract Surg. 2007 Jan;33(1):101-3. Shugar JK. Use of epinephrine for IFIS prophylaxis. J Cataract Refract Surg. 2006 Jul;32(7):1075-5. Myers WG, Shugar JK. Optimizing the intracameral dilation regimen for cataract surgery: Prospective randomized comparison of 2 solutions. J Cataract Refract Surg. 2009 Feb; 35: 273-6.