Pupil dilation with intracameral lidocaine during phacoemulsification

Abstract

During phacoemulsification, intracameral preservative-free lidocaine 1% provided rapid, effective mydriasis comparable that of topical mydriatics.

Intracameral Mydriatics in Cataract Surgery

“…The mean pupil dilation was 4.52±0.08mm in the intracameral group and 4.06±0.09 mm in the topical group, and no difference in the overall subjective surgical performance was noted. Similar results were also published the following year in the Indian Journal of Ophthalmology by the same group; in a case series of 31 consecutive cases the pupils dilated from 2.63±0.33 mm to 7.03±0.61 90 seconds after injection of 0.2 to 0.3 ml of preservative-free lidocaine 1%, and no negative effects on the surgical performance were noted (Nikeghbali, Falavarjani et al 2008). Jayadev and Nayak also published a short report on this regimen in 2007 (Jayadev and Nayak 2007).…”

“…Jayadev and Nayak also published a short report on this regimen in 2007 (Jayadev and Nayak 2007). Noticeably, both the studies by Nikeghbali (Nikeghbali, Falavarjani et al 2007;Nikeghbali, Falavarjani et al 2008) and Jayadev (Jayadev and Nayak 2007) demonstrate significantly larger pupils after intracameral lidocaine without preoperative topical mydriatics, than we have seen in our investigations (Lundberg and Behndig 2008). This difference in effect from intracameral lidocaine may be due to population differences, differences in lidocaine dosage, or the fact that the pupil size was measured 90 seconds after the intracameral lidocaine injection in the studies in question.…”

“…Furthermore, the subjective surgical performance was ranked as equally good for both groups. The studies from Nikeghbali et al (Nikeghbali, Falavarjani et al 2008) confirmed the results of a surgical performance similar to when using topical mydriatics.…”

“…The results from Cionni's study were confirmed in 2007 by Nikeghbali et al (Nikeghbali, Falavarjani et al 2007) in a prospective comparative case series including 57 patients randomized to receive either topical mydriatics (30 eyes) or intracameral lidocaine (27 eyes) to dilate the pupil. The topical mydriatics given consisted of 3 drops of cyclopentolate 1% and phenylephrine 5% given 5 minutes apart starting 60 minutes before surgery.…”

Comparison of pupil diameter and tear production in dogs treated with acepromazine, tramadol and their combination

“…The pupil diameter (PD) was measured with a caliper, read in millimeters (Nikeghbali et al 2007;Almeida et al 2008), manually adjusted according to the pupil diameter ( Figure 1A) oriented parallel to the corneal surface of the right eye of each animal, but without touching it (Figure 1 B). The evaluator stood in front of the animal, so that the dog's eyes were kept parallel to the table.…”