Maximal mydriasis evaluation in cataract surgery

Abstract

We propose the maximal mydriasis test (MMT) as a simple and safe means to provide the cataract surgeon with objective and dependable preoperative information on the idiosyncratic mydriatic response of the pupil. The MMT results of a consecutive series of 165 eyes from 100 adults referred for cataract evaluation are presented to illustrate the test's practical applications and value. The results enable the surgeon to anticipate problem eyes preoperatively so he or she can plan an appropriate and effective surgical strategy. The MMT has also improved out cost-effectiveness by cutting down unnecessary delays in the operating room and enabling better utilization of restricted costly resources.

Intracameral phenylephrine and ketorolac injection (OMS302) for maintenance of intraoperative pupil diameter and reduction of postoperative pain in intraocular lens replacement with phacoemulsification

“…Sufficient mydriasis during ILR is critical to a successful surgical outcome by providing visualization of the surgical field, a good red reflex, and adequate room for intraocular manipulation of surgical instruments 4,5. However, because pupil dilation is typically achieved by application of topical mydriatic agents preoperatively,6,7 the initial mydriatic effect achieved may not be sustained throughout the procedure, particularly in cases where the surgical trauma itself induces intraoperative miosis through prostaglandin-related stimulation of the iris 7–9.…”

Study of the Efficiency and Workflow of Femtosecond Laser Assisted Cataract Surgery in a Spanish Public Hospital

“…Comparison reports on Efficient Phaco time (EPT) in FLACS compared to conventional phacoemulsification are controversial: in some authors' work did not differ significantly 13,38,39 , whereas others reported statistically significant differences in favor of FLACS 3,16,29,37 . In our study, FLACS subgroups and MANUAL group did not show statistically significant differences.…”

Study of the efficiency and workflow of femtosecond laser-assisted cataract surgery in a Spanish public hospital

“…Comparison reports on Efficient Phaco time (EPT) in FLACS compared to conventional phacoemulsification are controversial: in some authors' work did not differ significantly 13,38,39 , whereas others reported statistically significant differences in favor of FLACS 3,16,29,37 . In our study, FLACS subgroups and MANUAL group did not show statistically significant differences.…”

“…This is consistent with previous studies showing laser cataract surgery took longer to complete compared to conventional phacoemulsification without accounting for the time taken to complete the laser procedure itself, being this due in part to irrigation-aspiration requiring more instrument maneuvers and taking longer to complete. 29,32 This fact may also be explained by the fact that more complex cataracts were included in FLACS II subgroup. Previous scientific evidence on the surgical time required with FLACS vs. conventional phacoemulsification have shown contradictory outcomes, with some authors reporting comparable surgical times, [35][36][37] whereas others concluding that FLACS was more time-consuming.…”

“…Patients with easily accessible sockets and good patient collaboration were included. Eligible cataracts ranged from nuclear opacities from NC1 to NC4, cortical opacities from C1 to C4 and posterior subcapsular from P1 to P4, according to the Lens Opacities Classifications System (LOCSIII); with good pupil dilation (minimum 8 mm, that was measured in the slit lamp as described by Ho et al 29 ) after the standard dilation protocol, i.e., instillation of tropicamide 1% and fenylephrine 10% eye-drops in the conjunctival sac, three times, each time separated by 10 minutes. Fuchs endothelial dystrophy and white cataracts were excluded.…”