Subconjunctival Atropine and Intracameral Epinephrine for Pupil Dilation in Phacoemulsification

Combined Subconjunctival Atropine and Intracameral Epinephrine Injection for Pupil Dilation in Phacoemulsification Under Peribulbar Anesthesia.

Mydriatic eye drops are routinely used before phacoemulsification but they are not free of drawbacks. Several alternatives were tried to overcome their limitations.

The study will include 20 patients with bilateral cataract (40 eyes). The experimental group will include eyes for which a new injectable mydriatic combination are used to dilate the pupil. The control group will include cases where standard mydriatic eye drops are used.

Inclusion Criteria:

• Cases of bilateral visually significant cataract

Exclusion Criteria:

• Poor pupil dilation(less than 6 mm diameter).
• History of previous eye surgery or trauma
• History of use of eye drops affecting pupil size such as pilocarpine.
• Known drug allergy to cyclopentolate,phenylephrine, atropine sulfate or epinephrine.
• Pediatric age group (less than 18 years old).
• Pupil abnormalities, such as anisocoria or neurological disorders.
• Associated glaucoma, uveitis, corneal, retinal or optic nerve disease.
• Cases scheduled for phacoemulsification under general anaesthesia (to exclude possible ocular and systemic effects or interactions of anaesthetic agents).
• Patients with bleeding tendency or on anti-coagulant therapy (because peribulbar and subconjunctival injections are used).