Intracameral mydriatic injection shown to be safe in pediatric cataract surgery
Intracameral injection of a mydriatic solution (tropicamide, phenylephrine, lidocaine) is a safe and effective method for achieving pupil dilation in children undergoing cataract surgery, with minimal systemic absorption and no significant hemodynamic side effects, according to a study.
In a prospective cohort study, researchers evaluated 40 pediatric patients, ranging from 8 weeks to 17 years of age, who received a single 0.1 mL intracameral injection containing tropicamide 0.02%, phenylephrine 0.31%, and lidocaine 1%. A second injection was administered during immediate sequential bilateral surgery to 13 children.
Systemic drug exposure and cardiovascular safety were monitored. The youngest patients showed detectable increases in plasma phenylephrine and tropicamide levels, but no clinically significant changes in blood pressure or heart rate were reported across any age group. The researchers noted that patients who received a second injection during bilateral surgery did not show increased drug levels or adverse effects.
Reference
Herbots H, Van Os L, Aerts W, et al. Evaluation of Systemic Exposure to Intracameral Tropicamide 0.02%, Phenylephrine 0.31%, and Lidocaine 1% in Pediatric Cataract Surgery. J Ocul Pharmacol Ther. 2025;doi: 10.1177/10807683251359451. Epub ahead of print. PMID: 40681312.
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