不同术式对白内障合并NPDR患者散瞳后瞳孔直径的影响

目的:探讨手法小切口白内障术(MSICS)和超声乳化(Phaco)白内障摘除术对白内障合并非增生期糖尿病性视网膜病变(nonproliferative diabetic retinopathy,NPDR)患者散瞳后瞳孔直径的影响。方法:前瞻性研究,选取核硬度达到III级(Emery法)的白内障合并NPDR患者45例60眼,分为MSICS组和Phaco组,每组30眼。白内障手术前后均采用复方托吡卡胺眼药水给予患眼散瞳,测量散瞳后瞳孔直径,两组术前及术后3mo的散瞳后的瞳孔直径进行比较。结果:MSICS组散瞳后瞳孔直径术前为6.23±0.83mm,Phaco组散瞳后瞳孔直径术前为6.26±0.85mm,两组差异无统计学意义(P>0.05)。MSICS组术前术后散瞳后瞳孔直径差值为0.11±0.094mm,差异有统计学意义(P<0.01);Phaco组术前术后散瞳后瞳孔直径差值为0.17±0.119mm,差异有统计学意义(P<0.01)。MSICS组和Phaco组之间术前术后散瞳后瞳孔直径差值的差异有统计学意义(P<0.05)。结论:白内障核硬度达到III级合并非增生期糖尿病性视网膜病变患者行MSICS和Phaco均可使散瞳后瞳孔直径变小,Phaco术可能对散瞳后瞳孔直径的影响更明显。     

白内障患者超声乳化术中瞳孔直径变化的临床分析

目的:研究白内障患者超声乳化术中瞳孔直径的变化,了解其对白内障超声乳化术影响。方法:区组设计,前瞻性研究。选取60例60眼白内障手术患者,根据年龄分为两组,年轻组(A组)20例2 0眼和老年组(B组)4 0例4 0眼。术前均采用复方托吡卡胺滴眼液充分散瞳,术中计算机软件处理图像,并且根据角膜的放大比例测量以下手术时相的瞳孔直径:作角膜隧道切口前(t1)、注入黏弹剂后(t2)、人工晶状体植入前(t3)、手术结束即刻(t4)。采用SPSS 18.0统计软件分析数据。结果:患者t1~t4的瞳孔直径测量值依次为:A组8.36±0.65,8.97±0.50,8.67±0.63,8.72±0.96mm;B组7.73±0.58,8.23±0.59,7.89±0.16,7.70±0.63mm。两组间总体的比较:在手术的不同时相,瞳孔直径测量值存在组间差别(F=26.696,P<0.05);两组中,在不同时间点的比较:t1~t4时相的瞳孔直径,A组均大于B组,差异有统计学意义(P<0.05)。各组患者的瞳孔直径测量值在手术的不同时相有变化的趋势(F=23.423,P<0.05),且两组变化趋势比较无显著性差异(F=2.617,P>0.05);同一组中,不同时间点的比较:各组内t2时相的瞳孔直径测量值均大于t1时相测量值,差异有统计学意义(P<0.05);各组内术中t2~t4时相瞳孔直径测量值两两比较,A组差异均无统计学意义(P>0.05),B组t3和t4时相瞳孔直径减小,差异均有统计学意义(P<0.05)。结论:复方托吡卡胺滴眼液术前散瞳下,年轻白内障患者和老年白内障患者均可达到手术所需散瞳效果,老年白内障患者超声乳化术中瞳孔稳定性低于年轻白内障患者。     

利多卡因在超声乳化白内障手术中的散瞳效果观察

目的探讨前房内注射利多卡因诱导散瞳在超声乳化白内障吸除术中的应用。设计随机对照临床研究。研究对象80例(86眼)白内障患者。方法将80例(86眼)随机分为观察组34例36眼,术中前房内注射不含防腐剂的1%利多卡因诱导散瞳。对照组46例50眼,术前复方托吡卡胺滴眼散瞳。两组均进行常规超声乳化白内障吸除联合人工晶状体植入术。以消毒卡尺分别测量并记录两组患者手术开始时、前房内注射利多卡因后90秒及两组术后1、2、4、8、12、24小时的瞳孔直径。主要指标瞳孔直径。结果观察组利多卡因前房注射前及注射后90秒末瞳孔直径分别为(2.0611±0.1016)mm、(6.0972±0.1566)mm,对照组手术开始时瞳孔直径(7.6100±0.0799)mm。后两者之间有显著性差异(P=0.000)。术后2小时之内,观察组75.0%瞳孔大小恢复正常,而对照组22.0%瞳孔恢复正常;两组瞳孔恢复时间有显著性差异(P=0.000)。结论前房内注射利多卡因能快速散瞳且能显著缩短术后瞳孔恢复时间;虽然其散曈效果不如复方托吡卡胺,但多数能够满足手术需要?ㄑ劭疲?2006,15:205-208)     

利多卡因在白内障超声乳化吸出术中的应用

目的研究前房内注射利多卡因在白内障超声乳化吸出术中的散瞳和麻醉效果。方法将100例100眼老年性白内障患者随机分为利多卡因组和常规组进行超声乳化吸出术。记录2组患者术中瞳孔直径、麻醉效果及术后1d视力、瞳孔直径,术后1周角膜内皮细胞密度,并观察手术并发症的发生情况。结果利多卡因组和常规组术中瞳孔直径分别为（7.25±0.45）mm及（7.44±0.58）mm,术后1d瞳孔直径分别为（2.58±0.60）mm及（2.55±0.56）mm,2组比较差异无统计学意义（P〉0.05）。2组患者术后1d视力均〉0.5（利多卡因组：0.5～0.7者12眼,0.7～1.0者31眼,〉1.0者7眼;常规组：0.5～0.7者13眼,0.7～1.0者29眼,〉1.0者8眼）,术后1周角膜内皮细胞丢失率分别为（5.92±1.48）%和（5.47±1.25）%,2组相比差异无统计学意义（P〉0.05）。而利多卡因组麻醉效果明显优于常规组,差异有统计学意义（P〈0.05）。结论白内障超声乳化吸出术中前房内注射不含防腐剂的体积分数1%利多卡因0.3～0.5mL,有扩瞳作用,不必术前常规散瞳,且麻醉效果好,安全可靠。     

前房麻醉在合并糖尿病白内障超声乳化中的应用

目的 探讨合并糖尿病的白内障超声乳化术中应用前房麻醉其稳定前房、散瞳及麻醉效果.方法 收集2007年2月至2008年1月就诊的糖尿病性白内障患者,随机分成两组,观察组20例(23只眼),给予爱尔凯因表麻联合1%的不含防腐剂的利多卡因前房麻醉,对照组20例(22只眼)给予单纯表面麻醉.全部患者均行晶状体超声乳化吸出联合人工晶状体植入手术,分析其麻醉效果及前房稳定情况.乳化后和术毕时瞳孔较术前的缩小值,术后瞳孔对光反应、术后1月较术前角膜内皮细胞的减少值,并观察手术并发症的发生情况.结果 麻醉效果两组间差异有统计学意义(P<0.05).乳化后及术毕时瞳孔较术前的缩小值组间差异有统计学意义(P<0.05).观察组术中前房稳定性较好,平均乳化时间48.3s,对照组乳化时间平均57.6s.术后瞳孔对光反应、术后1月较术前角膜内皮细胞的减少值组间差异无统计学意义,两组术后角膜水肿、房闪、前房纤维素性渗出等并发症组间差异无显著性.结论 合并糖尿病的白内障在超声乳化术中应用前房麻醉可散大并稳定术中瞳孔大小,增加麻醉效果和前房稳定性,利于手术操作,提高手术成功率,是安全、有效、容易普及的可行方法     

严重粘连性小瞳孔的白内障超声乳化术

目的探讨严重粘连性小瞳孔白内障超声乳化术的安全性及手术技巧。方法对26例(32只眼)粘连性小瞳孔白内障,术中采用透明角膜切口,散瞳后瞳孔直径(2.5±0.5)mm。以晶状体调位钩及chopper钩辅助,松解粘连,扩大瞳孔至4~5 mm,连续环形撕囊后进行原位白内障超声乳化吸除及折叠人工晶状体植入。结果术后3个月随访,术眼视力均较术前提高,其中视力≥0.5者20只眼(62.5%)。术后患眼瞳孔接近圆形或椭圆形,部分患者瞳孔直径较术前偏大。但其中2只眼再发部分后粘连,1只眼后囊少许破裂,仍植入人工晶状体,无人工晶状体明显偏位。结论采用上述技术不仅顺利完成小瞳孔白内障超声乳化术,且手术安全有效,视力恢复较好,保持或接近生理性圆,手术并发症相对减少。     

沐欣滴眼液预防白内障超声乳化术后高眼压的临床观察

目的:评价沐欣滴眼液预防白内障超声乳化术后高眼压的临床效果。方法:对66例(66眼)因老年白内障在我院行白内障超声乳化 人工晶状体植入术的患者随机分成两组。试验组(33例),在术前1d和术前1h给予沐欣滴眼液1滴。对照组(33例)在术前1d和术前1h给予人工泪液1滴。记录术前眼压和术后4,6,12,24h眼压,观察心率、血压等全身和眼部并发症。结果:术后24h对照组平均眼压为(17.11±2.23mmHg),试验组为(13.50±1.65mmHg),术后每个时间点对照组平均眼压均高于试验组,差异有统计学意义。两组术后眼压最高峰均在术后6h左右。同术前眼压比较,术后高峰眼压(术后6h)试验组有19例(57%)眼压比术前更低,对照组有7例(21%)眼压比术前更低。结论:对行白内障超声乳化术 人工晶状体植入的患者,术前给予沐欣滴眼液,能有效预防术后高眼压。     

Acrysof及Acrysof IQ人工晶状体植入术后视力对比研究

目的:探讨白内障超声乳化联合植入Acrysof、Acrysof IQ人工晶状体术后,在正常瞳孔(直径3mm)及暗光下(直径5～6mm)裸眼视力的关系。客观评价白内障超声乳化联合植入球面及非球面人工晶状体术后患者的视力情况,为白内障临床工作中根据患者的要求及生活情况选择相应的人工晶状体提供一定的参考。方法:年龄相关性白内障患者30例(43眼),分为Acrysof组18例(25眼)及AcrysofIQ组12例(18眼)。常规行白内障超声乳化联合折叠式人工晶状体植入术。分别记录术前最佳矫正视力及术后1wk在正常瞳孔(直径3mm)及暗光下(直径5～6mm)裸眼视力。采用SAS8.2统计软件对结果进行统计学分析。结果:(1)术前平均最佳矫正视力:Acrysof组4.244,Acry-sof IQ组4.283,差异无统计学意义。(2)Acrysof组:术后1wk在正常瞳孔(直径3mm)下平均裸眼视力4.904,暗光(直径5～6mm)下裸眼视力4.780,(P<0.05),差异有统计学意义。Acrysof IQ组:术后1wk在正常瞳孔(直径3mm)下平均裸眼视力4.944,在暗光(直径5～6mm)下裸眼视力4.933,差异无统计学意义。(3)术后1wk在正常瞳孔(直径3mm)下平均裸眼视力Acrysof组及AcrysofIQ组比较,差异无统计学意义。术后1wk在暗光(直径5～6mm)下裸眼视力Acrysof组及Acrysof IQ组比较(P<0.05),差异有统计学意义。结论:在正常瞳孔(直径3mm)下,Acrysof人工晶状体组及Acrysof IQ人工晶状体组视力无区别。但在暗光(直径5～6mm)下,AcrysofIQ人工晶状体组好于Acrysof人工晶状体组。     

基层医院开展白内障超声乳化的体会

在我国,基层医院能开展白内障超声乳化手术的为数不多。我院系县级医院,自1997年1月起开展白内障超声乳化手术,现将初步体会报告如下。一般资料:1997年1月至1999年1月共施行白内障超声乳化术126例168眼。其中男71例89眼,女55例79眼。年龄最大82岁,最小28岁,平均61岁。老年性白内障149眼;并发性白内障7眼;外伤性白内障12眼,其中2眼晶状体半脱位。1～2级核33眼,3级核87眼,4级核48眼。术前最低视力眼前数指,最高视力04。术后随访时间2～3月。手术方法:术前半小时美多丽眼液散瞳,球周或球后麻醉,加压软化眼球。切开球结膜缘约90度,距角膜缘后2～…     

超声乳化吸除及人工晶状体植入术治疗小瞳孔白内障的临床探讨

目的:探讨小瞳孔时的白内障超声乳化术的手术技巧和临床效果。方法:对23例(27眼)散瞳后小瞳孔的白内障患者采用钝性分离及非切开的牵拉法扩大瞳孔,进行原位超声乳化并人工晶状体囊袋内植入术。结果:术后随访6～12mo,所有病例术后视力较术前有不同程度的提高,术后视力0.1～0.2者5眼,0.3～0.5者14眼;0.8以上者8眼。结论:采用钝性分离及非切开的牵拉扩大瞳孔法,原位超声乳化可使小瞳孔的白内障恢复良好的视力和生理性圆瞳孔或近圆瞳孔,手术并发症少。     

Pupil dilation with intracameral lidocaine during phacoemulsification

PURPOSE: To evaluate pupil dilation by an intracameral injection of nonpreserved lidocaine 1% during phacoemulsification cataract extraction and compare the results with those using conventional topical mydriatics. SETTING: Department of Ophthalmology, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. METHODS: A prospective comparative case series study was conducted. The study included 57 patients who were given topical mydriatics (30 eyes) or intracameral lidocaine (27 eyes) to dilate the pupil for phacoemulsification and intraocular lens implantation. The topical group received 3 drops of cyclopentolate 1% and phenylephrine 5% given 5 minutes apart starting 60 minutes before surgery. The intracameral group received preservative-free lidocaine 1% (0.2 to 0.3 mL) injected just before the procedure began. No epinephrine was added to the irrigating solution. In both groups, the horizontal pupil diameter was measured before and after pupil dilation using the same caliper. Total surgical time, need for a mydriatic agent during the procedure, and subjective surgical performance were recorded. RESULTS: The mean age, sex, cataract density, baseline horizontal pupil diameter, and mean duration of the surgery were the same between the topical group and intracameral group. The mean pupil dilation was 4.52 mm +/- 0.08 (SD) in the intracameral group and 4.06 +/- 0.09 mm in the topical group; the difference between groups was statistically significant (P = .001). There was no significant difference between groups in the overall subjective surgical performance (P = .74). No patient in the intracameral group and 2 patients in the topical group required an intracameral mydriatic injection. CONCLUSION: During phacoemulsification, intracameral preservative-free lidocaine 1% provided rapid, effective mydriasis comparable that of topical mydriatics.     

Posterior chamber injection of intracameral mydriatics increases the durability of the mydriatic response

Purpose: To compare the mydriatic effect of intracameral mydriatics injected into the anterior or the posterior chamber in routine phacoemulsification cataract surgery. Methods: Forty‐four patients planned for unilateral phacoemulsification surgery were included after informed consent. Mydriasis was achieved by injecting 150 μl of a mixture of phenylephrine 1.5% and lidocaine 1.0% at the beginning of the procedure. The patients were randomly assigned to injection into the anterior or the posterior chamber. The pupils were filmed during the procedures, and the mean pupil diameters were measured at predetermined intervals from the video recordings by an independent observer. Results: Immediately after the injection, the pupils were larger after posterior chamber injection (3.8 ± 0.8 versus 3.1 ± 0.7 mm; p = 0.004). A similar difference was seen after the phacoemulsification (6.4 ± 0.7 versus 5.9 ± 1.0 mm; p = 0.031). The mydriatic durability was also better after posterior injection (p = 0.004–0.041). Conclusions: Apart from immediately after the injection, the initial mydriatic response was similar with both injection techniques, but the durability of the mydriasis was slightly better after a posterior chamber injection of ICM.     

两种散瞳剂在弱视儿童验光中的应用探讨

目的:探讨复方托吡卡胺滴眼液(美多丽)对5～9岁弱视儿童进行散瞳验光的可行性.方法:对30例(60眼)弱视儿童先后用两种散瞳剂(美多丽与阿托品眼膏)散瞳验光的结果进行对比.结果:近视组、散光组的差异无显著性;远视组美多丽与阿托品眼膏的验光结果之间有显著性差异,但两者存在相关性.结论:在特殊情况下,美多丽可以作阿托品的替代药对弱视儿童进行散瞳验光.     

The effect of mydriasis from phenylephrine on corneal shape

Purpose: A previous study reported that pharmacologically‐dilated pupils changed the corneal shape. Researchers used mydriatic agents with significant cycloplegic effect. The current study investigates the effect of mydriasis on corneal shape using phenylephrine alone, where phenylephrine has minimal effect on the accommodative system and whether corneal topography can be done after pupil dilation. Methods: Forty‐four young healthy subjects with one eye randomly selected for mydriasis were used in this study. Twenty‐two received one drop of 2.5% phenylephrine (group 1); the other 22 subjects had one drop of 0.4% benoxinate instilled prior to the application of 2.5% phenylephrine (group 2). They were matched for age and refractive error. Anterior chamber depth, pupil size and corneal parameters were compared before and after mydriasis. The corneal parameters included best‐fit sphere (BFS), surface asymmetry index (SAI), surface regularity index (SRI) and the axial and tangential powers in the form of flattest and steepest powers, and in the form of M, J₀, and J₄₅ vector presentation. Results: Group 1 and group 2 subjects had similar pre‐mydriatic baseline ocular parameters. The mean (± SD) pupil dilation was 1.24 ± 0.59 mm for group 1 and 1.80 ± 0.95 mm for group 2. The dilation was significantly larger in group 2 (unpaired t‐tests: t = 2.36, p = 0.02). There were no significant changes in corneal parameters from mydriasis in either group. Conclusions: Previous investigations used mydriatic agents, which affected not only the pupil size but also accommodation. The current study found that mydriasis from phenylephrine, with minimal effect on accommodation, did not result in significant corneal alteration, and corneal topography can be measured after pupil dilation with phenylephrine.     

不同年龄患者FLACS术中PI操作时瞳孔直径的变化

目的：探讨不同年龄患者飞秒激光辅助白内障手术(FLACS)中瞳孔直径变化的相关因素及其对患者接口(PI)操作时间和手术疗效的影响。

方法：选取2017-03/2018-06在我院行FLACS手术的白内障患者101例101眼,按照年龄分为中青年组(46例)和老年组(55例)。术前常规散瞳,记录PI操作时间、对接时间、劈核半径及PI操作前、中、后的瞳孔直径。术后采用状态焦虑问卷(SAI)评定患者PI操作中的状态焦虑症状,并评估临床疗效。

结果：本组患者年龄与PI操作前、中、后瞳孔直径、劈核半径、SAI评分均呈负相关; PI操作时间与SAI评分呈负相关。中青年组患者PI操作前、中、后瞳孔直径(8.89±0.57、7.52±0.52、8.96±0.54mm)均显著大于老年组(8.43±0.73、7.14±0.55、8.44±0.75mm),SAI得分(42.19±9.27分)显著高于老年组(39.80±9.15分)(均P<0.01),但两组患者PI操作时间、对接时间和治疗总有效率均无差异(P>0.05)。

结论：FLACS术中中青年患者瞳孔变化较为敏感,且焦虑情绪较为突出,对手术进程有一定影响。     

OASIS内置式虹膜扩张器在小瞳孔白内障超声乳化术中的应用

目的：观察OASIS内置式虹膜扩张器在小瞳孔白内障超声乳化术中的应用效果。

方法：选择2016-01/2017-10在我院接受治疗的小瞳孔白内障患者44例,随机分为对照组(22例31眼)和观察组(22例30眼),对照组采用劈核器和晶状体调位钩手动撕开扩张瞳孔行常规白内障超声乳化手术治疗,观察组在术中植入OASIS内置式虹膜扩张器扩大瞳孔行常规白内障超声乳化手术治疗,对两组患者手术前后最佳矫正视力(BCVA)、角膜内皮细胞计数、瞳孔直径及眼压变化情况进行对比分析,评价OASIS内置式虹膜扩张器的应用效果。

结果：术后1mo,两组患者BCVA 较术前均显著改善,且观察组患者BCVA(0.09±0.04)显著优于对照组(0.20±0.03),差异均有统计学意义(P<0.05)。术后1mo,两组患者角膜内皮细胞计数均较术前明显减少,但观察组患者角膜内皮细胞计数(2455.77±52.98个/mm²)显著高于对照组(2298.94±49.12个/mm² ),差异均有统计学意义(P<0.05)。术后1mo,两组患者瞳孔直径较术前均有所扩大(P<0.05),且观察组患者瞳孔直径(3.52±1.14mm)大于对照组(3.15±1.02mm); 术后6mo,两组患者瞳孔直径较术后1mo均显著扩大(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。术后1mo,两组患者眼压较术前均有所降低(P<0.05),且观察组眼压(13.40±1.73mmHg)低于对照组(13.93±1.98mmHg); 术后6mo,两组患者眼压均低于术后1mo(P<0.05),但两组间比较差异无统计学意义(P>0.05)。

结论：OASIS内置式虹膜扩张器用于小瞳孔白内障超声乳化术中可提高术后最佳矫正视力、降低眼压、扩张瞳孔直径,应用效果较好。     

Randomized clinical trial of the efficacy and safety of tropicamide and phenylephrine in preoperative mydriasis for phacoemulsification

Purpose: To compare the mydriatic effect and safety between different concentrations of tropicamide and phenyle­phrine in preoperative mydriasis for phaco­emulsification. Methods: Two hundred and seventeen consecutive eyes in the same number of Chinese patients undergoing phaco­emulsification under local or topical anaesthesia in a university‐based eye hospital were analyzed. Patients were randomized into two groups by cluster randomization, each group receiving a different preoperative mydriatic regimen. Regimen A consisted of tropicamide 1.0% with phenylephrine 2.5%, and Regimen B consisted of tropicamide 0.5% with phenylephrine 0.5%. The main outcome measures were horizontal pupillary diameter, systolic, diastolic and pulse pressure and pulse rate. Results: The group who received Regimen A attained a mean horizontal pupillary diameter of 7.00 ± 1.06 mm. Their pupils were significantly larger than those receiving Regimen B (6.61 ± 1.03 mm, P = 0.007). No untoward cardiovascular effects were noted in either groups. Conclusion: Regimen A attained better preoperative mydriasis for phacoemulsification than Regimen B. Both regimens were safe with regard to their cardiovascular effects. The combination of tropicamide 1.0% and phenylephrine 2.5% is recommended as preoperative mydriatic for phacoemulsification in Chinese patients who have darkly pigmented irides.     

Some factors affecting the ocular hypotensive and mydriatic responses of the rabbit to topically applied l-adrenaline bitartrate

Single topical treatment with l-adrenaline bitartrate in eyes of albino rabbits gave a prompt concentration-related increase in pupil diameter, peak values occurring at 1–2 hr. Ocular tension decrease commenced 2–3 hr after treatment, at the same time that the mydriatic effect started to decline. The decrease was concentration-related over approximately the same range as the pupil effect. Where a second topical treatment with a submaximal (0·5%) concentration of l-adrenaline bitartrate, equal to the first, was applied 3 or 4 hr later, a secondary delay in ocular hypotensive effect occurred and the tension returned to values not significantly different from controls for at least 1 hr. A second peak mydriasis occurred after the second treatment, equal in extent to the first. Onset of hypotension again coincided with offset of mydriasis. 0·25% l-Adrenaline bitartrate applied 3 hr after 0·5% caused a shorter secondary delay in tension fall and the mydriasis, although prolonged, did not give a further peak. 1% l-Adrenaline bitartrate applied 3 hr after 0·5% had similar effect on tension to the second treatment with 0·5%, but a significantly higher peak mydriasis occurred with 1%.No significant correlation was found between maximum observed pupil increases and tension decreases in a group of rabbits after a single treatment with a submaximal concentration of l-adrenaline bitartrate.0·5% l-Adrenaline bitartrate applied topically at 0 and 3 hr in the absence of tonometric procedures gave two equal peaks of mydriasis, but these were significantly lower than those found with similar treatment in the presence of tonometric procedures. Local anaesthetic applied for tonometry is implicated.     

Phacoemulsification without preoperative topical mydriatics: Induction and sustainability of mydriasis with intracameral mydriatic solution

Context:

Intracameral mydriatic solution can eliminate the disadvantages of repeated eye drop instillation regimen and provide adequate mydriasis for phacoemulsification with added advantages.

Aims:

Evaluating the role of intracameral irrigating solution (0.5% lignocaine + 0.001% epinephrine) in initiating and maintaining the pupillary mydriasis during phacoemulsification. Secondary aims were to observe the effect of surgical time, nucleus density and ultrasound time on mydriasis during the procedure.

Settings and Design:

The study is a prospective interventional case series, conducted at tertiary care institution.

Materials and Methods:

Thirty patients underwent phacoemulsification under topical anesthesia for visually significant cataract. Pupillary dilatation was achieved by intracameral irrigation of mydriatic solution alone. Pupillary diameter was measured serially during surgery and ultrasound time and total surgical time were noted.

Statistical Analysis Used:

Paired samples student–t test was done to compare means. Spearman correlation coefficient was used to study the effect of various parameters on mydriasis.

Results:

Thirty eyes completed the study. The pupil size increased from 2.1 mm (Range 2-3.5 mm SD ± 0.32) to 6.9 mm (Range 5-9 mm SD ± 1.02) in 30 seconds time after intracameral mydriatic solution delivery, and was 7.0 mm (Range 3.5 - 9 mm SD ± 0.20) at the end of surgery. Duration of surgery, grade of nucleus and ultrasound time had statistically insignificant effect on mydriasis.

Conclusions:

Intracameral solution containing 0.5% lignocaine and 0.001% epinephrine provides rapid mydriasis which is adequate for safe phacoemulsification and is unaffected by other parameters.