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An evaluation of intracameral mydriasis for routine cataract surgery
  1. Christopher B Schulz,
  2. Srini V Goverdhan,
  3. Roger C Humphry
  1. Eye Unit, Salisbury District Hospital, Salisbury, UK
  1. Correspondence to Christopher B Schulz, Eye Unit, Salisbury District Hospital, Odstock Road, Salisbury SP2 8BJ, UK; chrisschulz{at}doctors.org.uk

Abstract

Background Intracameral Mydrane might facilitate a more streamlined cataract service and improve the patient experience. There is limited ‘real-world’ evidence of its use in a UK setting.

Methods As part of a local evaluation of cataract surgery using intracameral Mydrane (group 2; n=60), data were collected on intraoperative pupil size and postoperative visual acuity (VA), as well as the rate of mechanical pupil dilation, intraoperative floppy iris syndrome (IFIS) and complications. Preoperative and theatre turnaround time was recorded and patients completed a validated measure of satisfaction postoperatively. Data were compared with a previous cohort subjected to the existing standard regime of preoperative topical mydriatics (group 1; n=60).

Results Postoperative VA was comparable between groups (0.09±0.16 vs 0.08±0.15; p=0.59). Pupil size in group 2 was 7.0±1.0 mm prior to capsulorhexis and 6.5±0.29 mm after cortical aspiration, with a smaller pupil in patients on alpha-antagonists (4.7±1.1 mm; p=0.004) at this later time point. Comparing group 2 with group 1, preoperative waiting was less (87 vs 146 min; p<0.0001) and satisfaction was higher (76.0±11.2 vs 66.3±8.6; p<0.0001), although theatre turnaround time was longer (25 min vs 22 min).

Conclusion Intracameral mydriasis was clinically effective in most patients undergoing cataract surgery and might be associated with an improved patient experience and a more streamlined preoperative flow. Mydrane represents a licensed alternative to the off-label use of other intracameral mydriatic agents, but was not judged to be a cost-effective intervention for routine use in this particular setting.

  • Lens And Zonules
  • Pharmacology
  • Pupil
  • Treatment Surgery

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Footnotes

  • Contributors All authors contributed to the study concept and design, the collection and interpretation of data and preparation of the final manuscript.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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