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Can J Ophthalmol. 2012 Apr;47(2):145-9. doi: 10.1016/j.jcjo.2012.01.007. Epub 2012 Mar 14.

Anaesthetic plus dilating gel improves pupil dilation for cataract surgery.

Author information

1
Department of Ophthalmology, Queen's University. Kingston, Ontario, Canada. delan.jinapriya@queensu.ca

Abstract

OBJECTIVE:

To evaluate the efficacy of a combination anaesthetic plus dilating gel (ADG) on pupil dilation (PD) and corneal anaesthesia (KA) compared to traditional preoperative pharmacotherapy for cataract surgery.

DESIGN:

Prospective, noninferiority study.

METHODS:

We studied 20 consenting adults who experienced unilateral cataracts and underwent routine cataract surgery, receiving the traditional preoperative pharmacologic regimen in the operated eye (control eye): diclofenac 0.1%, gentamicin 0.3%, cyclopentolate 1%, phenylephrine 2.5%, and tropicamide 1% 60 and 20 minutes prior to surgery. They then received tetracaine 0.5% and povidone-iodine 5% 10 minutes prior to surgery; and were given tetracaine 0.5%, povidone-iodine 5%, and lidocaine 2% gel 1 minute prior to surgery. Epinephrine 0.1%, 1 cc per 500 mL bag of balanced saline salt solution was administered during surgery. The nonoperated eye (study eye) received tetracaine 0.5%, povidone-iodine 5%, and 0.35 cc ADG gel (phenylephrine 10%, tropicamide 1%, diclofenac 0.1%, and lidocaine 2%) 60 and 10 minutes prior to surgery. PD and KA were measured at baseline, at 30 minutes, and at 5 minutes prior to surgery, and at 5 minutes after surgery.

RESULTS:

There was no difference in PD (p = 0.2634) or KA (p = 0.6058) between the study eyes and the control eyes at baseline. Preoperatively, greater mydriasis was achieved in the study eye (7.95 ± 0.91 mm vs 7.17 ± 1.25 mm; p < 0.0001). There was no significant difference in preoperative KA between the study and control eyes (1.5 ± 2.2 mm vs 1.4 ± 2.1 mm; p = 0.77).

CONCLUSIONS:

The combination ADG for preoperative preparation of cataract patients achieves at least equivalent dilation and corneal anaesthesia as the current preoperative pharmacologic regimen.

PMID:
22560419
DOI:
10.1016/j.jcjo.2012.01.007
[Indexed for MEDLINE]

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