Comparison Of Mydriasis With A Standardized Intracameral Combination Of Mydriatics (Mydrane®) Versus Preoperative Combination Of Mydriatic Eyedrops In Standard Cataract Surgery: A Real-Life Study.

Success of cataract surgery partly depends on the quality of mydriasis. Purpose of this study is to compare the same-eye mydriasis achieved with intraoperative Mydrane® (standardized intracameral solution of 0.2 mg/ml tropicamide, 3.1 mg/ml phenylephrine hydrochloride and 10 mg/ml lidocaine) to that achieved with a combination of mydriatic eyedrops (0.5% tropicamide, 2.5% phenylephrine hydrochloride and 1% cyclopentolate) preoperatively.

This is a single-centre prospective study conducted at the General Hospital of Xanthi in Greece.

Patients referred for cataract surgery were dilated at the preoperative consultation visit with a combination of mydriatic eyedrops. The pupil size was measured 45-60 minutes after mydriatic eyedrops instillation, using two different devices (Topcon corneal topography and IOLMaster 700). On the surgery day, mydriasis was achieved with Mydrane® injected intracameral. Thirty (30) seconds later, prior to the injection of viscoelastic, the pupil size was measured manually with a calliper under the surgical microscope. Also, an eye photograph was taken (screen shot) and pupil size was evaluated by two different examiners, using appropriate metrology software, in order to confirm the dilated pupil diameter measured manually intraoperatively.

Fifty (50) eyes were included in the study. The difference between the dilated pupil diameters achieved with the two different aforementioned mydriasis techniques was estimated using the paired samples Student's t-test. There was a statistically significant difference between the two different mydriasis techniques regarding the same-eye pupil dilation (p<0.001).

On average, pupil dilation achieved with Mydrane® is smaller than that achieved with the combination of mydriatic eyedrops. However, it remained sufficient for a successful capsulorhexis and lasted until completion of the most of the uncomplicated cases, helping to save preoperative time and additional cost of intracameral anaesthesia and mydriasis.