Official ESCRS | European Society of Cataract & Refractive Surgeons


Factors influencing Mydriasert® pupillary dilation in cataract surgery

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Session Details

Session Title: Cataract Surgery: Complications & Management

Session Date/Time: Tuesday 17/09/2019 | 14:00-16:00

Paper Time: 15:28

Venue: Free Paper Forum: Podium 1

First Author: : R.Romero Fontenlos UK

Co Author(s): :    S. Patra   S. Pipis   A. Vergados                       

Abstract Details


This study aimed to evaluate the effect of demographic and clinical factors on the efficacy of Mydriasert® for pre-operative mydriasis during cataract surgery.


The study was undertaken between February and March 2019, in a busy inner city hospital, with a multi ethnic population.


This is a prospective study of 58patients undergoing cataract surgery using Mydriasert® for pre-operative mydriasis. The primary outcome was the efficacy of Mydriasert® which was assessed by pupil size at the start and at the end of surgery. The secondary outcome included an analysis of factors associated with reduced efficacy (defined as preoperative pupil size <6mm) or poorly maintained pupil size (defined as ≤4mm at the end of surgery). The patients` pupil size was measured at baseline, at the start and at the end of surgery. Demographic data and clinical factors were analysed using SPSS statistical package


58 eyes were analysed (mean age 77±8.7 years). Pupil diameters at baseline, the start and end of surgery were 3.4±0.8mm,8±1.6mm and 7.8±1.9mm, respectively. 89.5% achieved a pupil size >6mm at the start of surgery, 19% required additional mydriatic aids and 3 patients (5.2%) had a final pupil size ≤4mm. Ethnicity was not a statistically significant factor neither influencing the efficacy of Mydriasert® pupillary dilation (p=0.897) nor requiring additional mydriatic aids (p=0.714). Baseline pupil diameter was associated with need of additional mydriatic aids (p=0.011) and poorly maintained pupil size (p=0.021). No other factors showed any statistically significant effect on pupil behaviour.


This study demonstrated the efficacy of Mydriasert® in achieving adequate pupillary dilation in most eyes despite clinical comorbidities, medication and ethnic groups. Nevertheless, surgeons should be aware that smaller baseline pupil size may indicate the need for additional aids for dilation and poorly maintained pupil size during surgery.

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