title: Comparing the efficacy of mydriatic cocktail-soaked sponge and conventional pupil dilation in patients using tamsulosin - a randomized controlled trial.
abstract: BACKGROUND
  A strong association exists between the use of tamsulosin and the occurance of intraoperative floppy iris syndrome. Several methods were advocated to overcome the progressive intraopertive miosis.Our purpose was to investigate the effect of a mydriatic-cocktail soaked cellulose sponge on perioperative pupil diameter in tamsulosin-treated patients undergoing elective cataract surgery.
  
  
  METHODS
  Patients using tamsulosin were dilated either with mydriatic-cocktail soaked sponge (group 1) or with conventional eyedrop regimen (group 2). Control patients not taking any α1 adrenergic receptor inhibtors were also dilated with mydriatic sponge (group 3).In all groups oxybuprocain 0.4%, cocain 4%, tropicamide 1%, phenylephrine 10%, diclophenac 0.1% along with chloramphenicol 0.5% were used preoperatively.Pupil diameter (mm) was measured preoperatively, after nucleus delivery, and before IOL implantation. Adverse effects associated with the use of sponge, minor and major intraoperative complications, the use of iris retractors and operation time were recorded.Differences in general between groups were analyzed with a one way analysis of variance (ANOVA); differences between groups in proportions were assessed by Fisher's exact test.
  
  
  RESULTS
  Mean pupil diameter (mm) was preopertively: 7.52 ± 1.21, 7.30 ± 1.55 and 7.99 ± 0.96 (ANOVA: p = 0.079); after nucleus delivery: 6 ± 1.20, 6.29 ± 1.12 and 6.52 ± 0.81 (ANOVA: p = 0.123); before IOL implantation: 5.46 ± 1.06, 5.83 ± 1.09 and 6.17 ± 0.89 (ANOVA: p = 0.0291).No adverse effect related to sponge use was detected. Frequency of minor complications, and iris hook use was similar in the two tamsulosin treated group. Operation time did not differ significantly in the three groups.
  
  
  CONCLUSIONS
  We have found that using a mydriatic cocktail-soaked wick - an alternative way to achieve intraoperative mydriasis for cataract surgery - was as effective and safe as the conventional repeated eyedrops regiment for tamsulosin treated patients.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN37834752.
authors.affiliation: Department of Ophthalmology, Thy-Mors Hospital, Højtoftevej 2, Thisted 7700, Denmark. janos.hargitai@rn.dk.
authors.forename: János
authors.initials: J
authors.lastname: Hargitai
authors.forename: László
authors.initials: L
authors.lastname: Vezendi
authors.forename: Jørgen
authors.initials: J
authors.lastname: Vigstrup
authors.forename: Finn
authors.initials: F
authors.lastname: Eisgart
authors.forename: Søren
authors.initials: S
authors.lastname: Lundbye-Christensen
authors.forename: Bálint
authors.initials: B
authors.lastname: Hargitai
authors.forename: Henrik
authors.initials: H
authors.lastname: Vorum
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000009:adverse effects*; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002387:Cataract Extraction / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D015877:Miosis / Q000517:prevention & control*; D009184:Mydriatics / Q000008:administration & dosage* / Q000494:pharmacology; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D011680:Pupil / Q000187:drug effects*; D013449:Sulfonamides / Q000009:adverse effects*; D000077409:Tamsulosin
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D009184:Mydriatics; D009883:Ophthalmic Solutions; D013449:Sulfonamides; D000077409:Tamsulosin