Intraindividual Comparison Between A Standardised Intracameral Combination And A Topical Standard Regimen For Mydriasis And Anesthesia In Cataract Surgery

To compare efficacy, safety, and stability of intraoperative mydriasis between an intracameral injection of Mydrane (tropicamide 0.02%, phenylephrine 0.31%, lidocaine 1%) and a topical standard regimen (tropicamide 0.5%, phenylephrine 10%, tetracaine 1%) in cataract surgery.

Department of Ophthalmology, Medical University of Graz, Austria.

Patients with indication for bilateral cataract surgery were included. One eye received an intracameral injection of Mydrane intraoperatively just after the first incision and the contralateral eye was treated with the topical standard regimen preoperatively. The sequence of treatment modality was randomized. The following outcome parameters were collected: frequency of additional pupil expanding measures, pupil diameter (PD) before capsulorhexis (T1), PD before IOL implantation (T2), PD before intracameral injection of cefuroxime (T3), and patient-reported pain perception.

74 eyes of 37 patients were included for analysis. PD in the Mydrane group were 6.97±1.00mm at T1, 7.68±0.93mm at T2, and 7.02±0.92mm at T3. In the standard regimen group PD were 8.47±1.01mm at T1, 8.02±0.95mm at T2, and 7.09±1.23mm at T3. Additional pupil expanding measures (topical or intracameral mydriatics and pupil expanding devices) were taken in three eyes in the Mydrane group and in one eye in the standard regimen group. No intraoperative complications were reported in both groups. Patient-reported pain perception was significantly lower in the Mydrane group (p=0.047).

Efficacy, safety, and mydriasis stability of intracameral Mydrane were comparable with a topical standard regimen in cataract surgery.