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Impact of intracameral instillation of epinephrine on the course of cataract surgery in patients with intraoperative floppy iris syndrome (IFIS)

Poster Details

First Author: N.Ondrova CZECH REPUBLIC

Co Author(s):    J. Cendelin                    

Abstract Details

Purpose:

To evaluate the effectiveness of intracameral instillation of epinephrine with lidocaine on manifestation and severity of IFIS in patients with history of alpha-1 adrenergic antagonist use in the treatment of benign prostate hyperplasia.

Setting:

Ofta Pilsen, Czech Republic

Methods:

Retrospective study examining the course of cataract surgery in patients with history of alpha-1 adrenergic antagonist use, in one eye with intracameral instillation of 0.1ml of epinephrine 1mg/ml with lidocaine, in the other eye without the use of epinephrine. The results include 38 eyes of 19 patients. We evaluated pupil diameter before the beginning of the operation after the instillation of mydriatic drops, after every stage of surgery and at the end of the operation. Furthermore we evaluated the number of iris prolapses, and iris aspirating into the phaco port and the aspiration cannula.

Results:

After statistical analysis of the gathered data we confirmed that epinephrine significantly improves mydriasis and its stability during the surgery. In 82% of evaluated patients, the diameter of the pupil was larger during and at the end of the operation in the eye with intracameral epinephrine instillation compared to the eye without intracameral epinephrine. The largest difference in the pupil diameter was during phacoemulsification, irigation and aspiration and after intraocular lens insertion, when the pupil was on average larger by 23%, 39% and 30% respectively. The intracameral epinephrine also reduced the number of iris prolapses and iris aspirations by 56%.

Conclusions:

Intracameral instillation of epinephrine with lidocaine appears to be effective and safe method to prevent IFIS related complications during cataract surgery. It improves significantly the stability of mydriasis during the surgery and reduces the number of iris prolapses and iris aspirations.

Financial Disclosure:

NONE

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