Protecting the Ocular Surface at the Time of Cataract Surgery: Intracameral Mydriatic and Anaesthetic Combination Versus A Standard Topical Protocol

Mencucci, Rita; Favuzza, Eleonora; Scali, G; Vignapiano, Roberto; Cennamo, Michela

doi:10.1007/s40123-020-00311-4

Cited by 9 publications

(10 citation statements)

References 34 publications

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“…Moreover, a recently published study showed that the use of this intracameral solution during cataract surgery could reduce ocular surface inflammation evaluated by in vivo confocal microscopy, assuring a better postoperative tear film stability and visual quality [ 47 ]. A recent report [ 48 ] has also indicated that persistent intraoperative surface irrigation may contribute to immediate postoperative dry eye symptoms.…”

Section: Intraoperative Managementmentioning

confidence: 99%

Iatrogenic Dry Eye Disease: Dealing with the Conundrum of Post-Cataract Discomfort. A P.I.C.A.S.S.O. Board Narrative Review

et al. 2021

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The incidence and prevalence of dry eye disease (DED) after cataract surgery is greatly underestimated. The severity of dry eye symptoms has been reported to peak 7 days after cataract surgery and may persist for months, significantly affecting patients' quality of life (QoL). The importance of considering surgical outcomes not only in terms of visual acuity, but also in terms of the patients' QoL, necessitates the assessment and evaluation of the ocular surface by the cataract surgeon prior to the procedure. This narrative review, drafted by the P.I.C.A.S.S.O. (Italian Partners for the Correction of Ocular Surface Alterations) board, analyses the physiopathology of post-cataract surgery DED and highlights the pre-, intra-and postoperative risk factors that may alter ocular surface homeostasis; it proposes a practical comprehensive algorithm for the prevention, treatment and management of DED associated with cataract surgery. Particular attention needs to be paid to the pre-and intraoperative risk factors to reduce the incidence of postoperative dry eye and to improve cataract surgery outcome.

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Section: Intraoperative Managementmentioning

confidence: 99%

Iatrogenic Dry Eye Disease: Dealing with the Conundrum of Post-Cataract Discomfort. A P.I.C.A.S.S.O. Board Narrative Review

et al. 2021

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“…It is worth emphasising that Mydrane® provides additional benefits to the patient by reducing systemic exposure to tropicamide/phenylephrine and lowering cardiovascular side effects (Guell et al, 2019 ). It also reduces ocular surface damage during cataract surgery (Mencucci et al, 2020 ; Souki et al, 2021 ) while providing a good safety profile (Labetoulle et al, 2016 ; Nazim‐Lipski et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Pupil diameter during cataract surgery after intracameral injection of the first ready‐to‐use combination of mydriatics and anaesthetic at the beginning of surgery in patients with a preoperative pupil diameter <6 mm

Kęcik

Grabska‐Liberek

Jurowski

et al. 2022

Acta Ophthalmologica

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Purpose We evaluated, in a real‐life setting, the effect of Mydrane® (ready‐to‐use combination of tropicamide, phenylephrine hydrochloride and lidocaine, injected into the anterior chamber at the beginning of cataract surgery to induce mydriasis and intraocular anaesthesia) on the pupil diameter during cataract surgery in patients with a preoperative pupil diameter <6 mm after the use of topical mydriatics. Methods We collected and analysed the data of 59 consecutive patients whose pupils dilated to a diameter <6 mm after the administration of mydriatic eye drops during the preoperative visit and who received Mydrane® during cataract surgery. Results In the group of 59 patients with a preoperative pupil diameter <6 mm after topical mydriatics, cataract surgery was performed in 36 patients (61.0%) using only Mydrane® to obtain mydriasis, with no additional drug or medical device. The mean pupil diameters in this group (36 of 59) during the preoperative assessment after topical mydriatics and just before capsulorhexis when Mydrane® was injected during surgery were 5.1 ± 0.74 and 6.15 ± 1.14 mm. Additional drugs were used in 23 patients (39%). In this group, the mean pupil diameters after topical mydriatics and just before capsulorhexis using Mydrane® were 4.58 ± 1.06 and 5.6 ± 1.26 mm, respectively. Conclusion In a real‐life setting, the mean pupil diameter achieved during cataract surgery after the intracameral injection of Mydrane® in patients with a preoperative pupil diameter <6 mm was over 1 mm larger than the mean pupil diameter after topical mydriatics, despite the trauma caused by the operation.

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“…In ophthalmic facilities, cataract surgery is performed more often than any other procedure, and many patients have reported experiencing dry eye symptoms afterwards. These symptoms can include irritation, burning, a foreign body sensation, drooping eyelids, redness, reflex lacrimation, ocular pain, and fatigue [5,6].…”

Section: Introductionmentioning

confidence: 99%

Ocular Surface Alterations Related to Cataract Surgery

Mohamed,

Nassar²,

Elsoht³

et al. 2023

JAMMR

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Background: Dry eye syndrome is a multifactorial disease of pre-corneal tear film that results in ocular discomfort, visual disturbance and tear film instability, with potential damage to the ocular surface. The aim of the work was to evaluate the ocular surface alterations related to cataract surgery either phacoemulsification or extracapsular cataract extraction surgeries. Methods: This prospective observational study included 60 patients with cataract. Patients were divided into 2 equal groups: Group1 included patients who had scheduled for phacoemulsification. Group 2 included patients who had scheduled for extracapsular cataract extraction surgery. All patients were subjected to full history taking, complete ophthalmic evaluation, OSDI score test, Schirmer tests, invasive break up time tests (IBUT), and non- invasive break up time tests (NIBUT). Results: Postoperative BCVA test in both groups was significantly better compared to preoperative tests after 1 week, 1 month, and 3 months while postoperative Schirmer test, IBUTT test, non IBUTT test, and OSDI test were significantly worse compared to preoperative in both groups after 1 week, 1month and 3 months (P value = 0.05). Conclusions: Patients who had scheduled for phacoemulsification showed a significantly better BCVA test, OSDI test, Schirmer test, IBUTT test, and non IBUTT test after 1 week, 1month and 3 months compared to extracapsular cataract extraction group.

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Protecting the Ocular Surface at the Time of Cataract Surgery: Intracameral Mydriatic and Anaesthetic Combination Versus A Standard Topical Protocol

Cited by 9 publications

References 34 publications

Iatrogenic Dry Eye Disease: Dealing with the Conundrum of Post-Cataract Discomfort. A P.I.C.A.S.S.O. Board Narrative Review

Iatrogenic Dry Eye Disease: Dealing with the Conundrum of Post-Cataract Discomfort. A P.I.C.A.S.S.O. Board Narrative Review

Pupil diameter during cataract surgery after intracameral injection of the first ready‐to‐use combination of mydriatics and anaesthetic at the beginning of surgery in patients with a preoperative pupil diameter <6 mm

Ocular Surface Alterations Related to Cataract Surgery

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