Digital Documentation Of Intracameral Epinephrine Effect On Pupil Dilatation During Clear Cornea-Phacoemulsification And Toric Iol Implantation

To document pupillary size change documentation following intraoperative intracameral epinephrine during phacoemulsification

Laservision Ambulatory Surgical Center, Athens, Greece.

A prospective interventional study carried out from April 2023 to October 2023 on 100 eyes. (65 patients). Effective aditional pupillary dilation following the intracameral infusion of 0,5 ml of 0.1mg/ml epinephrine solution prepared from the 1mg/ml vial by Demo Pharmaceudicals, Greece, will increase pupillary dilatation by at least 1mm in diameter prior to manual capsulorrhexis

The intraoperative image of relative pupil size to the total corneal will be compared to the respective pupil size following intracameral epinephrine administration and just prior to manual capsulorrhexis using our proprietary imaging software able to provide horizontal and vertical axis measurements to the 10^th of a mm

The use of intracameral epinephrine increased pupillary surface (S=π x r^{2 )}  by an average from 25.72 mm² to 38.06 mm². All cases were completed with the use of a toric IOL (Acrysof IQ Toric, Alcon, Ft Worth TX, USA). No intraoperative change in cardiac monitoring nor any cataract extraction complications were noted in any case

Intracameral epinephrine is a safe and effective alternative to manual intraoperative pupillary aperture stretching and / or the use of pupil dilatory devices such as iris hooks, Malyugin and other similar removable pupil mechanical expansion and maintenance rings  when dilation by usual topicaltropicamide and cyclopentolate solutions is not sufficient.