title: A paired comparison of intracameral mydriatics in refractive lens exchange surgery.
abstract: OBJECTIVE
  To compare the efficacy and intra-operative safety of intracameral mydriatics to topical mydriatics in patients undergoing refractive lens exchange (RLE) surgery.
  
  
  METHODS
  In a randomized intra-individually comparing study performed at Koskelas Eye Clinic, Luleå, and Department of Clinical Sciences/Ophthalmology, Umeå University Hospital, Umeå, Sweden, 56 patients undergoing same-day bilateral RLE were included. Pupils were randomly dilated with topical mydriatics in one eye and intracameral mydriatics in the fellow eye. Pupil sizes were recorded intra-operatively throughout the procedures. Perceived pain/discomfort and glare were assessed immediately postoperatively using a visual analogue scale from 0 to 10.
  
  
  RESULTS
  Topical mydriatics and intracameral mydriatics both give satisfactory pupil dilation in routine RLE. However, there was noticeable iris billowing in 17 eyes dilated with topical mydriatics but only one eye with intracameral mydriatics (p < 0.001). Pupils were initially slightly larger in the topical mydriatics group but contracted during surgery. There was no perceived difference with regards to glare, pain or discomfort between the treatments. The surgeon graded intracameral mydriatics eyes as easier to operate on.
  
  
  CONCLUSIONS
  Both topical mydriatics and intracameral mydriatics give satisfactory mydriasis for RLE, but pupil constriction and iris billowing are more pronounced with topical mydriatics.
authors: Department of Clinical Sciences/Ophthalmology, Umeå University, Umeå, Sweden.
authors: Oskar
authors: O
authors: Lundqvist
authors: Timo
authors: T
authors: Koskela
authors: Anders
authors: A
authors: Behndig
mesh_terms: D000287:Administration, Topical; D000867:Anterior Chamber / Q000187:drug effects; D003519:Cyclopentolate / Q000008:administration & dosage*; D004338:Drug Combinations; D058447:Eye Pain / Q000175:diagnosis; D005260:Female; D019466:Glare; D006801:Humans; D007498:Iris / Q000187:drug effects / Q000503:physiopathology; D019654:Lens Implantation, Intraocular; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D018918:Phacoemulsification; D010656:Phenylephrine / Q000008:administration & dosage*; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects* / Q000502:physiology
chemical_list: D004338:Drug Combinations; D009184:Mydriatics; D009883:Ophthalmic Solutions; C546419:phenylephrine, lidocaine drug combination; D010656:Phenylephrine; D008012:Lidocaine; D003519:Cyclopentolate
keywords: mydriatic; phacoemuslification surgery; pupil; refractive lens exchange