Maintenance of mydriasis with one bolus of epinephrine injection during phacoemulsification.
Surgically-induced miosis commonly occurs during cataract extraction surgery, complicating removal of lens cortex and placement of a posterior chamber intraocular lens. To maintain intraoperative mydriasis, one bolus of epinephrine injection was used in our study. The pupillary response to various doses of intracameral epinephrine (0.1 ml of 1:25,000, 1:50,000, 1:100,000, 1:200,000, 1:400,000) was assessed in 60 consecutive patients. The pupil size was measured just prior to the incision, one min after epinephrine injection, after phacoemulsification and after irrigation/aspiration. There was no significant difference among the mean mydriatic responses to the epinephrine concentrations we tested. The 1:400,000 concentration appeared to be as effective as 1:25,000, but two cases of the 1:400,000 group failed to maintain the pupil diameter after irrigation/aspiration. In addition, we found that blood pressure did not elevate after injection of any concentration of epinephrine. We concluded that one bolus of an extremely dilute concentration of epinephrine (i.e., 1:400,000) injection might be effective in maintaining mydriasis during cataract surgery without systemic side effects.
Liou
S W
SW
Taipei Medical University, Department of Ophthalmology, Municipal Jen-Ai Hospital, Taiwan, Republic of China. swanliou@pcmail.com.tw
Chen
C C
CC
D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D015877:Miosis / Q000517:prevention & control; D009184:Mydriatics / Q000008:administration & dosage*; D018918:Phacoemulsification; D011680:Pupil / Q000187:drug effects*
D009184:Mydriatics; D004837:Epinephrine