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Comparing the efficacy of a mydriatic cocktail-soaked sponge and conventional pupil dilation in patients using tamsulosin

Poster Details

First Author: A.Galbo Jacobsen DENMARK

Co Author(s):    H. Vorum   S. Lundbye-Christensen   B. Hargitai   J. Hargitai     

Abstract Details



Purpose:

Our purpose was to study the effect and safety of a mydriatic-cocktail soaked sponge on perioperative pupil diameter in tamsulosin-treated patients undergoing elective cataract surgery.

Setting:

Department of Ophthalmology, Thy-Mors Hospital, Thisted, Denmark

Methods:

Patients using tamsulosin due to benign prostatic hypertrophy were dilated either with a mydriatic-cocktail soaked sponge (group 1) or with a conventional eyedrop regiment (group 2). Control patients not taking any α1 adrenergic receptor inhibtors were also dilated with a mydriatic sponge (group 3). In all groups oxybuprocain 0.4%, cocaine 4%, tropicamide 1%, phenylephrine 10%, diclophenac 0.1% along with chloramphenicol 0.5% were used preoperatively. Pupil diameter was measured with 0.5 mm increments in the horizontal plain before surgery, after nucleus delivery and before intraocular lens implantation (IOL) using Geuder Castroviejo caliper. Adverse effects associated with the use of a sponge, minor and major intraoperative complications, the use of iris retractors and operation time were recorded. Differences in general between groups were analyzed with a one way analysis of variance (ANOVA); differences between groups in proportions were assessed by Fisher's exact test.

Results:

Mean pupil diameter (mm) was preopertively: 7.52±1.21, 7.30±1.55 and 7.99±0.96 (ANOVA: p=0.079) ; after nucleus delivery: 6±1.20, 6.29±1.12 and 6.52±0.81 (ANOVA: p=0.123); before IOL implantation: 5.46±1.06, 5.83±1.09 and 6.17±0.89 (ANOVA: p=0.0291). There was no adverse effect that could be related to the use of a sponge. Frequency of minor complications, and the need to use iris hooks was similar in the two tamsulosin treated groups. Operation time did not differ significantly in the three groups.

Conclusions:

In conclusion we have found that using a mydriatic cocktail-soaked sponge - an alternative way to achieve intraoperative mydriasis for cataract surgery - was as effective and safe as the conventional repeated eyedrops regiment in tamsulosin using patients. Though this method did not provide clinical differences or benefits compared to the conventional method, it may serve as a safe and timesaving alternative preoperative protocol even for high risk tamsulosin treated patients. FINANCIAL INTEREST: NONE

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