Cuan AY, Montero DE, Álvarez MJ, Bauza FY, Hormigó PIF

Language: Spanish
References: 19
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ABSTRACT

Objective: Evaluate the ocular and systemic safety of a combination of 2% lidocaine and 1% phenylephrine administered intracamerally to achieve intraoperative mydriasis in cataract surgery.
Methods: A prospective study was conducted of a case series of 70 patients (70 eyes) who underwent phacoemulsification with intraocular lens implantation. The intraoperative mydriasis group was composed of 35 patients dilated with an intracameral injection of lidocaine and phenylephrine before surgery, whereas another 35 eyes were dilated by the conventional method, with mydriatic eye drops. Ocular safety evaluation was based on the analysis of a wide variety of pre- and postoperative ophthalmological examination parameters.
Results: Intraocular pressure, central corneal thickness, corneal endothelial cell density and postoperative corneal edema as an anterior segment finding, behaved in a similar manner in both study groups. An intraoperative complication was reported in the conventional method group and a case with postoperative cystoid macular edema in the intraoperative mydriasis group group, neither of them exhibiting significant differences.
Conclusion: Intracameral lidocaine plus phenylephrine injection is a safe ocular and systemic option to achieve mydriasis during phacoemulsification.

REFERENCES

1. Cuan Aguilar Y, Montero Díaz E, Álvarez Martínez J, Pérez Candelaria E,Cárdenas Díaz T, Hormigó Puertas I. Midriáticos intracamerales en la cirugíade catarata. Rev Cubana Oftalmol. 2019 [acceso: 22/04/2021];32(1):e691.Disponible en:http://revoftalmologia.sld.cu/index.php/oftalmologia/article/view/691/html_383

2. Guell J, Behndig A, Pleyer U, et al. Systemic exposure to intracameral vs.topical mydriatic agents in cataract surgery. Clin Ophthalmol. 2019;13:811-9.

3. Cuan Aguilar Y, Montero Díaz M, Bauza Fortunato Y, Trujillo Fonseca K,Barroso Lorenzo R, Gutiérrez Castillo M. Eficacia del uso combinado delidocaína y fenilefrina como midriáticos intracamerales en la cirugía decatarata. Rev Cubana Oftalmol. 2020 [acceso: 22/04/2021];33(2):e818.http://revoftalmologia.sld.cu/index.php/oftalmologia/article/download/818/pdf_55

4. Srinivasan S. Intracameral mydriatics during cataract surgery. J Cat RefrSurg. 2018;44(3):257-8. DOI: https://doi.org/10.1016/j.jcrs.2018.03.007

5. Davey K, Chang B, Purslow C, Clay E, Vataire A. Budget impact model ofMydrane®, a new intracameral injectable used for intraoperative mydriasis,from a UK hospital perspective. BMC Ophthalmol. 2018;18(1):104. DOI:https://doi.org/10.1186/s12886-018-0746-x

6. Lundberg B, Behndig A. Intracameral mydriatics in phacoemulsificationcataract surgery – a 6-year follow-up. Acta Ophthalmol. 2013;91(3):243-6.

7. Lundberg B, Behndig A. Intracameral mydriatics in phacoemulsificationcataract surgery. J Cat Refr Surg. 2003;29(12):2366-71.

8. Cionni RJ, Barros MG, Kaufman AH, Osher RH. Cataract surgery withoutpreoperative eyedrops. J Cat Refr Surg. 2003;29(12):2281-3.

9. Myers WG, Shugar JK. Optimizing the intracameral dilation regimen forcataract surgery: prospective randomized comparison of 2 solutions. J CatRefr Surg. 2009;35(2):273-6.

10. Cuan Aguilar Y, Da Silva Ramos R, Montero Díaz E, Hormigó Puertas I,Pérez Candelaria E, Cárdenas Díaz T. Factores asociados a la hipertensiónocular después de una facoemulsificación no complicada. Rev CubanaOftalmol. 2018 [acceso: 22/04/2021];31(2). Disponible en:http://www.revoftalmologia.sld.cu/index.php/oftalmologia/article/view/579/491

11. Chang TC. Long-term effect of phacoemulsification on intraocularpressure using phakic fellow eye as control. J Cat Refr Surg. 2012;38(5):866-70.

12. Mansberger SL. Reduction in intraocular pressure after cataractextraction: the Ocular Hypertension Treatment Study. Ophthalmology.2012;119(9):1826-31.

13. Lundberg B. Safety and efficacy of intracameral mydriatics in cataractsurgery. J Cat Refr Surg. 2003;29:2366-71.13. Abid FC. Microscopia endotelial de córnea. En: Centurión V, Nicoli C,Chavez ME. Critalino de la Américas. La Cirugía del Cristalino. Panamá:Jaypee Highlights Medical Publishers; 2016. P. 185-204.

14. Saverio Sorrentino F, Bonifazzi C, Parmeggiani F, Perri P. A Pilot Study toPropose a "Harm Scale", a New Method to Predict Risk of Harm to the CornealEndothelium Caused by Longitudinal Phacoemulsification. PLoS One.2016;11(1):e0146580. DOI: https://doi.org/10.1371/journal.pone.0146580

15. He X, Diakonis VF, Alavi Y, Yesilirmak N, Waren D, Donaldson K.Endothelial cell loss in diabetic and nondiabetic eyes after cataract surgery.Cornea. 2017;36(8):948-51.

16. American Academy of Ophthalmology. Lens and Cataract. Basic andclinical Science Course 2016- 2017. San Francisco: American Academy ofOphthalmology; 2017.

17. Anastasilakis K, Mourgela A, Symeonidis C, et al. Macular edema afteruncomplicated cataract surgery: a role for phacoemulsification energy andvitreoretinal interface status? Eur J Ophthalmol. 2015;25:192-7.

18. Johansson M, Lundberg B, Behndig A. Optical coherence tomographyevaluation of macular edema after phacoemulsification surgery withintracameral mydriatics. J Cat Refr Surg. 2007;33:1436-41.

19. Stavert B, McGuinness MB, Harper CA, Guymer RH, Finger RP.Cardiovascular adverse effects of phenylephrine eyedrops; a systematicreview and meta-analysis. JAMA Ophthalmol. 2015;(133):647-52.