Preoperative topical  cyclopentolate can be omitted  when using intracameral  lidocaine in phacoemulsification  surgery.
OBJECTIVE
To evaluate the mydriatic effect of topical cyclopentolate 1% when combined with topical phenylephrine 10% and intracameral lidocaine 1% in phacoemulsification cataract surgery.


METHODS
We performed a prospective, double-masked, randomized trial including 20 patients with age-related cataract, who were scheduled for unilateral phacoemulsification and intraocular lens (IOL) implantation. Patients were given either two drops of phenylephrine 10% at 30 mins and 15 mins prior to surgery (group 1), or two drops each of cyclopentolate 1% and phenylephrine 10% at the same time points (group 2). All patients were also given lidocaine 1% intracamerally at the beginning of the procedure. Intraoperative pupil sizes were assessed from video-recordings.


RESULTS
Initially, pupil sizes were significantly smaller in group 1 (4.8 +/- 1.2 mm versus 6.5 +/- 1.4 mm; p = 0.0098), but the lidocaine injection increased the pupil sizes in group 1 significantly, so that pupil sizes in both groups were equalized throughout the surgical procedure.


CONCLUSIONS
Preoperative topical cyclopentolate does not enhance mydriasis in phacoemulsification surgery when using intracameral lidocaine and can be omitted when intracameral lidocaine is used.
Department of Clinical Sciences/Ophthalmology, Umeå University Hospital, Umeå, Sweden.
Björn
B
Lundberg
Anders
A
Behndig
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002387:Cataract Extraction / Q000379:methods*; D003519:Cyclopentolate / Q000008:administration & dosage*; D004311:Double-Blind Method; D005123:Eye; D005260:Female; D006801:Humans; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage*; D018918:Phacoemulsification; D011300:Preoperative Care; D011680:Pupil / Q000187:drug effects; D016896:Treatment Outcome
D000779:Anesthetics, Local; D009184:Mydriatics; D008012:Lidocaine; D003519:Cyclopentolate