TOPICAL MYDRIATICS IN SMALL-INCISION CATARACT EXTRACTION

Abstract

Purpose. To evaluate a mydriasis efficacy of topical 5% phenylephrine and 0.8% tropicamide combination in phacoemulsification by direct intraoperative measurement.Material and methods. In 50 cases mydriasis cased by 5% phenylephrine and 0.8% tropicamide combination (Mydrimax) were measured before surgery with the «Park 1» refractometer and on each phacoemulsification stage by with a0.5 mm calibrated spatula. Additional mydriasis caused by subconjunctival atropine and mesatone injection was assessed.Results. In 86% of the cases the mydriasis was sufficient for phacoemulsification. Pupil constriction after nucleus removal averaged 1.3±0.4mm. An additional dilation of pupil was required in 26% of cases. Factors correlated with rigid pupil were recorded. Results reported showed that subconjunctival atropine and mesaton injection in case of rigid pupil after maximal topical mydriatics could cause improvement in the pupil size. Otherwise, in cases with sufficient topical mydriasis injection no additional effect was recorded. Decrease of mydriatic effect was recorded when Mydrimax was reused after less then after 24 hours. An optimal preoperative application scheme was recommended.Conclusions. 5% phenylephrine and 0,8% tropicamide combination (Mydrimax) provides sufficient mydriasis for phacoemulsification. For optimal result before surgery topical mydriatic contains adrenergic agonist should not be used 24 hour before Mydrimax application.

Keywords

• phacoemulsification
• mydriasis
• midrimax
• rigid pupil