Cataract Surgery
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Compounded fixed-combination injection provides stable mydriasis during surgery

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An intracameral mydriatic injection resulted in rapid and stable mydriasis during cataract surgery or combined cataract surgery/MIGS, according to a poster presented at the 2021 ASCRS Annual Meeting by Tigran Kostanyan, MD, ABO.

In this observational, single-center study, 42 patients undergoing cataract surgery or combined cataract surgery/MIGS received an intracameral injection of a compounded mydriatic solution containing a fixed combination of tropicamide 0.02%, phenylephrine HCl 0.3%, lidocaine HCl 1%, and diclofenac 0.01%.  The mean time to dilate was 26.4 ± 6 seconds.

Pupil diameter preoperatively was 1.8 ± 0.5 mm, 10-30 seconds after injection it was 5.9 ± 0.9 mm; and before intraocular lens insertion it was 7.0 ± 0.8 mm. After injection, 64.2% of patients achieved a pupil diameter ≥6 mm. Before lens implantation, 69.04% of patients achieved a pupil diameter ≥6 mm.

Dr Kostanyan said that in his experience, “this compounded fixed-combination is more convenient than drops and provides more stable mydriasis than injected lidocaine+phenylephrine.”

He concluded his presentation by saying that compared to lido+phenylephrine this intracameral mydriatic injection may reduce the need for pupil expansion devices.

Kostanyan T. Intracameral Mydriasis During Cataract Surgery and Cataract Combined with Minimally Invasive Glaucoma Surgery. Presented at: 2021 ASCRS Annual Meeting.

Dr Kostanyan disclosess that he is a consultant for ImprimisRx.

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