Maintenance of Mydriasis with Epinephrine During Cataract Surgery

Abstract

SUMMARY The pupillary response to various doses of intraocular epinephrine (0.1 ml of 1:16,000, 1:32,000, 1:64,000, 1:80,000, or 1:96,000) was studied in 55 consecutive patients during extracapsular cataract surgery. The 1:16,000 epinephrine concentration provided a mean 0.74 mm increase in pupil diameter (range 0.0 to 1.7 mm) when administered to re-dilate the pupil after nucleus expression. The mean increase in pupil area with 1:16,000 epinephrine was 27% which greatly facilitated removal of lens cortex in most cases. However, 25% of all pupils failed to dilate with epinephrine 1:16,000. The other concentrations provided essentially the same mydriasis as the 1:16,000 concentration. Pupils smaller than 6 mm dilated more easily than pupils larger than 6 mm. Iris color, age, or sex had no significant effect on the mydriatic response. It is concluded that an extremely dilute concentration of epinephrine (i.e., 1:96,000 or less) may be effective in maintaining mydriasis during cataract surgery.

Comparison of the effects of 1/10,000 and 1/100,000 concentrations of intracameral epinephrine on corneal endothelium and macular thickness after uncomplicated phacoemulsification

“…Although several studies have evaluated the efficacy of different concentrations of this drug, the concentration remains unknown. In the study on 55 patients during extracapsular cataract surgery, the pupillary responses to various doses of intraocular epinephrine have been studied and the authors concluded that an extremely dilute concentration of epinephrine (i.e., 1:96,000 or less) may be effective in maintaining mydriasis during cataract surgery [19]. Liou et al have also studied the pupillary response to various concentrations of intracameral epinephrine during cataract surgery.…”