Assessment of effect of intracameral 0.02% tropicamide, 0.31% phenylephrine, 1% lidocaine in initiation and maintenance of the pupillary mydriasis during phacoemulsification under topical anaesthesia
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 2078-2085
AbstractThis clinical study was conducted to assess the effect of intracameral 0.02% tropicamide, 0.31% phenylephrine, 1% lidocaine in initiation and maintenance of pupillary mydriasis during phacoemulsification under topical anaesthesia.
Materials & methods: This study was conducted on randomly selected 100 patients with immature or mature senile cataract, who were planned for phacoemulsification followed by intraocular lens implantation. All patients selected for intracameral injection were instilled with single drop of topical anaesthetic proparacaine 0.5% three times, five minutes before surgery. Pre prepared 0.2 ml combination of mydriatic and anaesthetic agents was given intracameral to all patients undergoing surgery after initial clear corneal incision. All data was analysed by using statistics software SPSS 26, IBM, USA. Pearson Chi-square test, Pearson correlation 2-tailed tests were used for statistical analysis. p-values of <0.05 were considered significant.
Results: It was observed that a maximum of 7.54±0.44 mm mean mydriasis was achieved with ICM combination of mydriatics and anaesthetic in all patients. Mean time taken to achieve maximum mydriasis was 8.92±1.64 seconds. Sustained mydriasis was observed in 99% of cases throughout the surgery. A statistically significant positive correlation was observed in patient’s comfort and surgeon’s comfort. Highly significant difference in preoperative and postoperative BCVA was observed statistically.
Conclusion: Intracameral injection of 0.02% of tropicamide + 0.31% phenylephrine + 1% lidocaine, along with topical anaesthesia, is rapid, effective and safe in inducing and maintaining intra-operative mydriasis in phacoemulsification, as demonstrated by pupillary diameter measurements during surgery, patient's feedback and surgeon’s feedback.
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