Efficacy and effect of intracameral adrenaline infusion on pulse rate and blood pressure during phacoemulsification in patients with dark irides.

OBJECTIVE

Phacoemulsification is the most common cataract surgery that needs optimum circumstances in the field of surgery. This comparative pre- and postoperative study assessed the efficacy and safety of using adrenaline in the irrigating solution as an adjunct to preoperative topical mydriatics in dark irides during Phaco surgery.

PATIENTS AND METHODS

This was a prospective observational study that enrolled 421 cataract patients (421 eyes) with dark irides, who were scheduled for Phaco surgery from January 2019 to August 2020. All patients received intraoperative irrigation of a balanced salt solution containing adrenaline. The pulse rate and systolic and diastolic blood pressure of all patients were recorded pre- and postoperatively. In addition, the presence of intraoperative floppy-iris syndrome (IFIS), need for pupil mechanical dilatation, and incidence of posterior capsular rupture were recorded.

RESULTS

The sample consisted of 421 patients (421 eyes) all had dark irides. Pulse rate and systolic and diastolic blood pressure did not significantly increase post-operatively (p <0.001). Mechanical dilatation of the pupil was performed in one patient (0.24%) and seven eyes (1.66%) were found to have IFIS. There was no case of posterior capsule rupture.

CONCLUSIONS

In comparison with the use of preoperative topical mydriatics alone, adding intracameral adrenaline to the irrigation fluid maintains better pupillary dilatation throughout Phacoemulsification surgery, thereby providing better clinical outcomes in dark irides, even in those with IFIS. Its use has no incremental effect on either blood pressure or pulse rate.