Intraoperative intracameral carbachol in phacoemulsification and posterior chamber lens implantation.
OBJECTIVE
To evaluate the use of intraoperative intracameral carbachol in association with phacoemulsification and posterior lens implantation.


METHODS
We prospectively randomly assigned 41 eyes (41 patients) to receive either placebo or a 50:50 dilution of carbachol 0.01% after intraocular lens insertion and phacoemulsification.


RESULTS
Twenty-one eyes of 21 patients treated with intracameral carbachol showed a statistically significant (P = .0373) reduction in intraocular pressure (15.9 mm Hg) at 6 hours postoperatively compared with 20 eyes of 20 patients who had received placebo (20.4 mm Hg). At day 1, the carbachol group measured 15.0 mm Hg vs 17.6 mm Hg for placebo (P = .0376), and a 1.5-line improvement in visual acuity in the carbachol vs the placebo group was noted (P = .0263), which was maintained on glare testing. On quality of life testing using a modified SF-36 test, carbachol-treated patients within the first postoperative week more often attempted to descent stairs in both bright (P = .007) and dim (P = .037) light than did patients treated with placebo. At month 2, no difference was observed between groups except that depth of focus was statistically greater in the carbachol group (P = .025). Safety was similar between the two groups in terms of ocular and systemic adverse events.


CONCLUSIONS
Patients treated with carbachol intracamerally after phacoemulsification and posterior chamber lens implantation demonstrate lower intraocular pressure within the first day postoperatively. These findings are associated with improved visual acuity and potentially greater ambulation in bright light within the first postoperative week.
Solomon
K D
KD
Department of Ophthalmology, Medical University of South Carolina, Charleston, USA.
Stewart
W C
WC
Hunt
H H
HH
Stewart
J A
JA
Cate
E A
EA
D000368:Aged; D000867:Anterior Chamber; D002217:Carbachol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007430:Intraoperative Care; D019654:Lens Implantation, Intraocular; D008297:Male; D008916:Miotics / Q000008:administration & dosage*; D009798:Ocular Hypertension / Q000209:etiology / Q000517:prevention & control; D009883:Ophthalmic Solutions; D018918:Phacoemulsification / Q000009:adverse effects; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
D008916:Miotics; D009883:Ophthalmic Solutions; D002217:Carbachol