DOI: 10.36347/sjams.2022.v10i02.019

Pages: 248-252

Purpose: To compare the results of pupil dilation by an intracameral injection of preservative free 1% lidocaine with conventional topical mydriatics during phacoemulsification cataract surgery. Comparison was also done for simultaneous anaesthetic effect between intracameral lidocaine and topical mydriatics. Methods: A randomized, comparative interventional study was conducted. The study included 50 patients who underwent phacoemulsification and intraocular lens implantation surgery and were divided in two groups. One group was given topical mydriatics (25 eyes) preoperatively and other intracameral lidocaine (25 eyes) at commencement of surgery to dilate the pupil. The topical group received 3 drops of tropicamide 0.8% and phenylephrine 5% eye drops 15 minutes apart starting 45 minutes before surgery. The intracameral group received preservative-free lidocaine 1% (0.2 to 0.3 mL) injected just before the procedure began. In both groups, the horizontal pupil diameter was measured before and after pupil dilation using the same caliper. Total surgical time, need for a supplement mydriatic agent during the surgery and subjective surgical performance were recorded. Any adverse ocular and systemic effects between two groups were also compared. Results: The mean age, sex, cataract grading, baseline horizontal pupil diameter and mean surgerical time were similar between the topical and intracameral group. The mean pupil dilation was 4.62 ± 0.96 mm in the intracameral group and 4.76 ± 0.75 mm in the topical group. There was no statistically significant difference between the two groups (P value =0.57).There was no significant difference between groups in the overall subjective surgical performance (P=0.72). No patient in any group required supplementary intracameral mydriatic injection. Conclusion: Intracameral lidocaine is a safe, effective and reliable alternative to topical mydriatic for pupil dilation with added advantages of fast postoperative recovery and is also ....