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European observatory of cataract practice: maintaining Mydriasis in cataract surgery in 2015

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Session Details

Session Title: Cataract II
Session Date/Time: Saturday 27/02/2016 | 08:30-11:00
Paper Time: 10:54
Venue: Trianti Room
First Author: : M.Tassignon BELGIUM
Co Author(s): :                  

Abstract Details


A sufficient and stable mydriasis is a prerequisite to allow visualization of the capsulorhexis and lens and to ensure operational safe conditions during the entire cataract surgery. Cataract surgery and intraocular lens implantation requires a maximally dilated pupil to provide optimal access to the lens. Maximum mydriasis and corneal clarity during intraocular surgery are mandatory to ensure operational safety. The main objective of the current survey is to understand and assess therapeutic protocols and the clinical practices related to cataract surgery. This abstract is focused on the results related to mydriasis procedure in cataract surgery.


Antwerp University and University Hospital of Antwerp, Department of Ophthalmology, Belgium.


To be eligible for inclusion, cataract surgeons were required to have at least 5 years of practice and to undertake at least 150 cataract operations yearly. Surgeons were included pro rata depending on the number of cataract surgeons in each country. Surgeons completed a 40 item questionnaire divided into nine categories; screening, surgeon profile, surgical procedure, therapeutic strategies, product use before arrival at the operating room (OR), techniques for mydriasis and anesthesia, product use at the OR, product use after the patient leaves the OR, surgeons’ attitude to guidelines.


Mydriasis was most commonly initiated by a nurse in the ambulatory centert (76%), followed by initiation at home (13%) and in the operating room. Surgeons rated “stable dilation” and “largest size” as the most important factors. Eye drops (80%) and inserts (21%) were most commonly used in the surgical center. When initiated in the operating room, eye drops were most commonly used (74%) and intracameral injection in 19%. Additional mydriatics were used in 14%: adrenaline (epinephrine) (36%) and phenylephrine (33%). Moreover, 7.2% of the cataract surgeries were delayed due to pupil dilatation problems(12.8 minutes on average).


The results from the European Observatory in Cataract Surgery related to mydriasis highlighted that in the context of cataract surgery, mydriasis is mainly initiated by a nurse in the ambulatory conditions with tropicamide and phenylephrine eye drops used in combination. Additional mydriatics were needed in 14% of cataract operations. Dilatation related to surgical delays is an important issue for surgeons. The average delays are almost equivalent to a cataract surgery time. According to surgeons, stable and large pupil dilatations are the most important criteria to perform CS in good conditions.

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