Intracameral anaesthetic mydriatics as adjuvant aids in small pupil cataract surgery to reduce the use of Pupillary Expansion Devices: A randomized prospective cohort study from Central Kerala, India

Merine Paul

Authors

Merine Paul I Care Centre, Thrissur, Kerala.

Abstract

ABSTRACT:

BACKGROUND:

To determine if Intracameral Anaesthetic Mydriatics (ICAM) can improve

pupillary dilatation in Small Pupil Cataract Surgery (SPCS) and reduce the use

of Pupillary Expansion Devices (PED) in SPCS.

METHODS:

A randomized prospective cohort study of 94 patients who met the inclusion criteria in private hospital setting in Central Kerala. India, were included in the study. Patients were randomized into two groups A and B, with Group A receiving intracameral Phenocaine Plus prior to capsulorhexis and none in Group B. Pupillary measurements were taken at, preoperative, start of surgery, post Phenocaine Plus injection, post Hydro dissection, post Phacoemulsification and post IOL implantation, stages of surgery. The demographic and clinical data collated were subject to statistical analysis.

RESULTS:

Thirty-six (75%) patients in Group A dilated to 6 mm or beyond, prior to capsulorhexis with the use of ICAM. This advantage in pupillary dilation was present in all stages of the surgery at statistically significant levels. The use of PED did not vary significantly between the groups. Group B had more intraoperative complications compared to group A but the difference was not statistically significant.

CONCLUSIONS:

ICAM as an adjuvant in small pupil cataract surgery helps to dilate and

maintain dilation of the pupil at all stages of surgery. ICAM did not

significantly impact the use of PED in this study, however, multicenter studies

with a larger pool of cataract surgeons are required to further explore the lack of

difference.

KEY WORDS:

ICAM, Small Pupil Cataract Surgery, Phenocaine Plus, Pupillary Expansion Devices.

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