Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes

Rajesh Subhash Joshi Department of Ophthalmology, Vasantrao Naik Government Medical College, Yavatmal, India Aim: To study the effect of intracameral injection of preservative-free lignocaine to induce pupil dilatation, without using any preoperative dilating eyedrops or intraoperative mydriatics...

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Autor principal:	Joshi RS
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Phacoemulsification Type -2 diabetes Intracameral lignocaine topical anesthesia intracameral mydriatic solution. Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/b769a8394e194fcbab60051b0bc30a8e
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spelling	oai:doaj.org-article:b769a8394e194fcbab60051b0bc30a8e2021-12-02T06:32:44ZPhacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes1177-5483https://doaj.org/article/b769a8394e194fcbab60051b0bc30a8e2016-12-01T00:00:00Zhttps://www.dovepress.com/phacoemulsification-without-preoperative-mydriasis-in-patients-with-ag-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Rajesh Subhash Joshi Department of Ophthalmology, Vasantrao Naik Government Medical College, Yavatmal, India Aim: To study the effect of intracameral injection of preservative-free lignocaine to induce pupil dilatation, without using any preoperative dilating eyedrops or intraoperative mydriatics in patients with age-related cataract associated with type 2 diabetes mellitus. Design: This was a prospective, observational, and interventional case series conducted at a tertiary eyecare center in rural India. Materials and methods: A total of 32 patients underwent phacoemulsification under topical anesthesia for visually significant cataract. Preoperative pupillary diameter was measured 3 days prior to surgical procedure under mydriatics (tropicamide 0.8%, phenylephrine hydrochloride 5%). Intraoperative pupillary dilatation was achieved by 1% intracameral lignocaine solution alone. Effective phacoemulsification time (EPT), total surgical time, and final pupillary diameter were recorded at the conclusion of surgery. Results: The average duration of diabetes was 11.2 (range 5–25) years. There was no difference in dilatation by preoperative pupil-dilating drops (5.2±0.5 mm, range 3–8.3 mm) and intracameral 1% lignocaine during the surgical procedure (P=0.63). There was a negative correlation (r=-0.92) between diabetes duration and dilatation of pupils with dilating drops and intracameral lignocaine. The duration of the surgery, EPT, and phacoemulsification chop had statistically insignificant effects on mydriasis, while the grade of the nucleus had a statistically significant effect on mydriasis. Intracameral lignocaine had no significant effect on blood pressure or pulse. There were no surgical complications that could have compromised the visual outcome. None of the patients developed macular edema in a follow-up period of 3 months; 28 patients (87.5%) had best-corrected visual acuity from 20/30 to 20/20. Conclusion: Intracameral lignocaine 1% provides sufficient mydriasis for the safe phacoemulsification of cataract in patients with type 2 diabetes of variable duration. Keywords: phacoemulsification, type 2 diabetes, intracameral lignocaine, topical anesthesia, intracameral mydriatic solutionJoshi RSDove Medical PressarticlePhacoemulsificationType -2 diabetesIntracameral lignocainetopical anesthesiaintracameral mydriatic solution.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 10, Pp 2427-2432 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Phacoemulsification Type -2 diabetes Intracameral lignocaine topical anesthesia intracameral mydriatic solution. Ophthalmology RE1-994
spellingShingle	Phacoemulsification Type -2 diabetes Intracameral lignocaine topical anesthesia intracameral mydriatic solution. Ophthalmology RE1-994 Joshi RS Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes
description	Rajesh Subhash Joshi Department of Ophthalmology, Vasantrao Naik Government Medical College, Yavatmal, India Aim: To study the effect of intracameral injection of preservative-free lignocaine to induce pupil dilatation, without using any preoperative dilating eyedrops or intraoperative mydriatics in patients with age-related cataract associated with type 2 diabetes mellitus. Design: This was a prospective, observational, and interventional case series conducted at a tertiary eyecare center in rural India. Materials and methods: A total of 32 patients underwent phacoemulsification under topical anesthesia for visually significant cataract. Preoperative pupillary diameter was measured 3 days prior to surgical procedure under mydriatics (tropicamide 0.8%, phenylephrine hydrochloride 5%). Intraoperative pupillary dilatation was achieved by 1% intracameral lignocaine solution alone. Effective phacoemulsification time (EPT), total surgical time, and final pupillary diameter were recorded at the conclusion of surgery. Results: The average duration of diabetes was 11.2 (range 5–25) years. There was no difference in dilatation by preoperative pupil-dilating drops (5.2±0.5 mm, range 3–8.3 mm) and intracameral 1% lignocaine during the surgical procedure (P=0.63). There was a negative correlation (r=-0.92) between diabetes duration and dilatation of pupils with dilating drops and intracameral lignocaine. The duration of the surgery, EPT, and phacoemulsification chop had statistically insignificant effects on mydriasis, while the grade of the nucleus had a statistically significant effect on mydriasis. Intracameral lignocaine had no significant effect on blood pressure or pulse. There were no surgical complications that could have compromised the visual outcome. None of the patients developed macular edema in a follow-up period of 3 months; 28 patients (87.5%) had best-corrected visual acuity from 20/30 to 20/20. Conclusion: Intracameral lignocaine 1% provides sufficient mydriasis for the safe phacoemulsification of cataract in patients with type 2 diabetes of variable duration. Keywords: phacoemulsification, type 2 diabetes, intracameral lignocaine, topical anesthesia, intracameral mydriatic solution
format	article
author	Joshi RS
author_facet	Joshi RS
author_sort	Joshi RS
title	Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes
title_short	Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes
title_full	Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes
title_fullStr	Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes
title_full_unstemmed	Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes
title_sort	phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/b769a8394e194fcbab60051b0bc30a8e
work_keys_str_mv	AT joshirs phacoemulsificationwithoutpreoperativemydriasisinpatientswithagerelatedcataractassociatedwithtype2diabetes
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Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes

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