[Phacoemulsification without mydriasis before surgery: benefits to the patient].
OBJECTIVE
The aim of our study was to evaluate the frequency of side effects (ataxia, dizziness and dry mouth) due to systemic absorption of parasympatholytic eye-drops, before phacoemulsification.


METHODS
This single surgeon, prospective, randomized and controlled study included 303 consecutive patients selected to undergo phacoemulsification with topical and intracameral anesthesia. Patients were distributed in two groups; those receiving no mydriatics before surgery (n=151) as control group and those dilated with cyclopentolate 1% and tropicamide 1% eye-drops (n=152) as the study group. Ataxia, dizziness and dry mouth were recorded in both groups by the same observer. Surgery time and changes in systolic and diastolic blood pressures were noted. Note was also taken of the cases where pupil widening maneuvers and a second intracameral instillation of lidocaine 1% plus epinephrine 1/200,000 were needed.


RESULTS
Fifteen patients (9.9%) suffered ataxia in the study group vs. three patients (2%) in the control group. Twenty-three patients (15.1%) suffered dizziness in the study group vs. two patients (1.3%) in the control group. Thirty patients (19.7%) experienced dry mouth in the study group vs. ten patients (6.6%) in the control group. No significant changes in blood pressures, surgery time and pupil dilating maneuvers were noted between groups. The odds ratio for a second intracameral instillation was 2.0 in the control group vs. the study group.


CONCLUSIONS
Lidocaine 1% plus epinephrine 1/200,000 as an adjunct to topical anesthesia during phacoemulsification showed to be an effective and safe alternative to abolish side effects caused by systemic absorption of mydriatics eye-drops before surgery.
Clínica de Cirugía Ocular, Madrid. j.benatar@telefonica.es
J
J
Benatar-Haserfaty
L
L
Alvarez de Rementería-Fernández
A
A
Muriel García
D000368:Aged; D003519:Cyclopentolate / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage* / Q000009:adverse effects; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects; D018918:Phacoemulsification / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*; D016896:Treatment Outcome; D014331:Tropicamide / Q000008:administration & dosage* / Q000009:adverse effects; D014792:Visual Acuity
D009184:Mydriatics; D009883:Ophthalmic Solutions; D003519:Cyclopentolate; D014331:Tropicamide