1. 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.

2. 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

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

4. 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.

5. 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”

6. 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.

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

8. 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

9. 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

10. 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.

11. References
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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 Jan;33(1):101-3.
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