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Cataract Surgery
Conference Roundup

Compounded fixed-combination injection provides stable mydriasis during surgery

Posted on August 4, 2021

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.

Reference
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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