DR. LIONAL RAJ

Abstract

Purpose: To compare topical(T) and intracameral(IC) mydriatic agent tropicamide with phenylephrine and its effect on the endothelium.

Methods: Adult cataracts not denser than Gr III, healthy endothelium, ACD (2 to 3 mm), AL (23 to25 mm) with no pupillopathy were randomized in 1:1 ratio. Gr-1 received topical Tropicamide 0.8% before surgery. Gr-2 received 0.2cc intra-cameral fixed combination Tropicamide 0.02%, Phenylephrine 0.31% & Lidocaine1%. Time dilation in sec., max. dilation in mm, endothelial cell loss at 1 month was analyzed.

Results: 46 eyes. Time taken for maximal dilation in Gr-1 was 2604 +/-45 sec(43.4 +/- 7.5min) & 7.09 +/- 1.72 sec. in Gr-2 (p <0.0001). Intra-op max. pupillary dilation(p=0.81), post-op mean endothelial loss(p=0.07) were comparable Conclusions: This RCT demonstrated instant mydriasis and sustained analgesia with single fixed combination intracameral injection within seconds, which could reduce preparation time & had no adverse effects post-surgery