Intracameral mydriatics versus topical mydriatics in pupil dilation for phacoemulsification cataract surgery

Suan, Amelia Lim Lay; Hamzah, Jemaima Che; Ken, Tan Soo; Mansurali, Vanessa Naseem

doi:10.1016/j.jcrs.2017.05.031

Cited by 25 publications

(20 citation statements)

References 9 publications

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“…2 We have observed increases in the use of intracameral mydriatics in contemporary ophthalmology. [3][4][5] In 2015, the first ready-to-use, standardized, commercially manufactured medicinal product Mydrane (Laboratoires Thea, France) was approved for use in several European countries, including Poland. 6 The product is injected into the anterior chamber at the beginning of cataract surgery to induce mydriasis and intraocular anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Stable Mydriasis After Intracameral Injection of a Combination of Mydriatics and Anesthetic During Cataract Surgery: A Real-Life, Multicenter Study

Kęcik

Grabska‐Liberek

Jurowski

et al. 2020

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To evaluate the effect of Mydrane (contains tropicamide, phenylephrine hydrochloride, and lidocaine hydrochloride) on time needed to induce mydriasis and mydriasis stability during cataract surgery. Methods: This was an observational, non-interventional, multicenter study of patients undergoing cataract surgery who received Mydrane for mydriasis and intraocular anesthesia. The study was conducted at seven ophthalmology departments at university hospitals in Poland. Patients admitted for cataract surgery within a 2-week period were asked to participate in the study. Patients whose pupils dilated to a diameter ≥6 mm after topical mydriatic administration during preoperative examinations were scheduled to receive Mydrane and included in the registry. No additional inclusion criteria were used. Patients' medical histories, examination results, and operative details were recorded. Pupil diameter was measured during surgery. Surgeons were asked to complete a Likert-based survey in parallel. Results: A total of 307 patients were enrolled. The mean pupil diameter was 7.0 ± 1.0 mm before capsulorhexis and 6.9 ± 1.2 mm before lens implementation. A pupil diameter ≥6 mm was achieved in 91.9% and 87.6% of patients before capsulorhexis and lens implantation, respectively. We asked 58 surgeons whether they agreed with the statement “Mydriasis was obtained in a short time after the administration of Mydrane”; the surgeons agreed with this statement after 92.2% (283/307) of surgeries. In addition, after 88.2% of surgeries, the surgeons agreed with the statement “Mydriasis was stable after the administration of Mydrane.” Conclusions: Mydriasis was rapidly and stably obtained after Mydrane injection, as demonstrated by pupil diameter measurements during surgery and surgeons' feedback.

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Section: Introductionmentioning

confidence: 99%

Stable Mydriasis After Intracameral Injection of a Combination of Mydriatics and Anesthetic During Cataract Surgery: A Real-Life, Multicenter Study

Kęcik

Grabska‐Liberek

Jurowski

et al. 2020

Journal of Ocular Pharmacology and Therapeutics

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“…7,8,14 Finally, mydriatics in Mydrane are less concentrated, and thus systemic safety is improved. 10 In conclusion, this study in real-life showed that Mydrane significantly reduced the pre-operative time and nurse workload, reducing costs in some clinical centres. However, this required organisational adaptations in other centres.…”

Section: Discussionmentioning

confidence: 66%

“…7,8,14 Finally, mydriatics in Mydrane are less concentrated, and thus systemic safety is improved. 10…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it was suggested that the reduction of total operating time (pre-surgical and surgical time) should translate in faster turnover of patients and improved productivity and cost-effectiveness. 7,9,10 In the present study, our objective was to compare the perioperative time including the preoperative workup, surgery and postoperative time and the cost from the clinic perspective of the Mydrane strategy versus conventional topical eye drops.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative time and economic impact of an intracameral combination of mydriatics and anaesthetics in routine cataract surgery

Zaluski

Amzallag²,

Bouchut³

et al. 2022

European Journal of Ophthalmology

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Purpose The aim of this study was to compare the perioperative time and economic impact of a licensed intracameral anaesthetic/mydriatic combination (Mydrane) during routine cataract surgery. Methods A real-life, prospective, comparative study was performed in 3 clinical centres in France. Preoperative, surgical, and post-operative times were determined for two mydriasis strategies using conventional preoperative mydriatics/anaesthetics eye drops (control regimen) or Mydrane administered at time of surgery. Staff, surgery schedules and drugs utilisation were collected over 12 surgery half-days. The total cost of each strategy was estimated based on treatment cost and nursing costs. Results The analysis included 112 routine cataract surgeries (57 surgeries using Mydrane and 55 using the topical regimen) without protocol deviations or complicated surgery. Overall, the mean time between administration of the first mydriatic eye drops or Mydrane and the end of the surgery was 27.4 ± 21.1 min in the Mydrane group vs. 90.3 ± 30.4 min in the control group (P < 0.0001). The total time of the procedure (from admission to discharge) was not significantly different between groups (P = 0.1611). On average, the extra cost of drugs per patient in the Mydrane group (€5.81) was almost balanced by the reduced nursing time (€5.57) with some variations between centres, due to different organisation including staff resource and consumable. Conclusions The Mydrane strategy produced perioperative nursing time saving and cost reduction provided that adaptation and reorganisation of routine cataract surgery are implemented.

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“…При введении в переднюю камеру р-ра фенилэфрина 1 % или эпинефрина 0,015 % также далеко не всегда удается эффективно добиться требуемой степени мидриаза при ригидном зрачке [149,176,181,182,187,216,219] Для достижения мидриаза при проведении ФЭ на глаукомных глазах используют механические способы расширения ригидного зрачка (различные ирис-ретракторы, зрачковые кольца). Но это создает риск кровотечения из зрачкового края радужки, а в послеоперационном периоде -нарушение формы и подвижности зрачка, развитие спаек, способствует формированию гифемы, кератопатии, подъема ВГД [15,39,130,144,217,220].…”

Section: возможности достижения мидриаза при узком ригидном зрачкеunclassified

Prediction of an increase in intraocular pressure after phacoemulsification in patients with glaucoma

Kolenko¹,

Sorokin²,

Postupaeva³

2022

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Монография посвящена вопросам прогнозирования и профилактики повышения внутриглазного давления после выполнения факоэмульсификации у пациентов с первичной открытоугольной глаукомой на основевыявленных диагностических критериев, позволяющих производить отборпациентов в группу риска для осуществления своевременного комплекса лечебно-профилактических и хирургических мероприятий. В книге систематизированы факторы риска и сформирован прогностический алгоритм выявления повышения внутриглазного давления в отдаленном послеоперационном периоде факоэмульсификации. Предложены методики хирургии, снижающие травматизм операции, позволяющие предотвратить расстройства гидродинамики глаза.

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Intracameral mydriatics versus topical mydriatics in pupil dilation for phacoemulsification cataract surgery

Abstract: Intracameral mydriatic agents dilated heavily pigmented pupils for phacoemulsification cataract surgery. However, in the early stages of surgery, pupil dilation was slower than with topical agents.

Cited by 25 publications

References 9 publications

Stable Mydriasis After Intracameral Injection of a Combination of Mydriatics and Anesthetic During Cataract Surgery: A Real-Life, Multicenter Study

Stable Mydriasis After Intracameral Injection of a Combination of Mydriatics and Anesthetic During Cataract Surgery: A Real-Life, Multicenter Study

Perioperative time and economic impact of an intracameral combination of mydriatics and anaesthetics in routine cataract surgery

Prediction of an increase in intraocular pressure after phacoemulsification in patients with glaucoma

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