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手术开始时在术前瞳孔直径<6mm 的患者的前房内注射首支即用型散瞳和麻醉合剂后白内障手术中的瞳孔直径。

Pupil diameter during cataract surgery after intracameral injection of the first ready-to-use combination of mydriatics and anaesthetic at the beginning of surgery in patients with a preoperative pupil diameter <6 mm.

机构信息

Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland.

Department of Ophthalmology, Medical Centre for Postgraduate Education, Warsaw, Poland.

出版信息

Acta Ophthalmol. 2023 Feb;101(1):e81-e87. doi: 10.1111/aos.15218. Epub 2022 Aug 16.

Abstract

PURPOSE

We evaluated, in a real-life setting, the effect of Mydrane® (ready-to-use combination of tropicamide, phenylephrine hydrochloride and lidocaine, injected into the anterior chamber at the beginning of cataract surgery to induce mydriasis and intraocular anaesthesia) on the pupil diameter during cataract surgery in patients with a preoperative pupil diameter <6 mm after the use of topical mydriatics.

METHODS

We collected and analysed the data of 59 consecutive patients whose pupils dilated to a diameter <6 mm after the administration of mydriatic eye drops during the preoperative visit and who received Mydrane® during cataract surgery.

RESULTS

In the group of 59 patients with a preoperative pupil diameter <6 mm after topical mydriatics, cataract surgery was performed in 36 patients (61.0%) using only Mydrane® to obtain mydriasis, with no additional drug or medical device. The mean pupil diameters in this group (36 of 59) during the preoperative assessment after topical mydriatics and just before capsulorhexis when Mydrane® was injected during surgery were 5.1 ± 0.74 and 6.15 ± 1.14 mm. Additional drugs were used in 23 patients (39%). In this group, the mean pupil diameters after topical mydriatics and just before capsulorhexis using Mydrane® were 4.58 ± 1.06 and 5.6 ± 1.26 mm, respectively.

CONCLUSION

In a real-life setting, the mean pupil diameter achieved during cataract surgery after the intracameral injection of Mydrane® in patients with a preoperative pupil diameter <6 mm was over 1 mm larger than the mean pupil diameter after topical mydriatics, despite the trauma caused by the operation.

摘要

目的

我们在真实环境中评估了 Mydrane®(在白内障手术开始时注入前房的托品酰胺、盐酸苯肾上腺素和利多卡因的即用型组合,用于诱导散瞳和眼内麻醉)对术前瞳孔直径<6mm 的患者在使用局部散瞳剂后白内障手术期间瞳孔直径的影响。

方法

我们收集并分析了 59 例连续患者的数据,这些患者在术前就诊时滴用散瞳剂后瞳孔直径扩大至<6mm,并在白内障手术期间接受了 Mydrane®治疗。

结果

在术前应用局部散瞳剂后瞳孔直径<6mm 的 59 例患者中,36 例(61.0%)仅使用 Mydrane®进行白内障手术以获得散瞳,无需额外药物或医疗设备。在该组(59 例中的 36 例)中,在术前评估时使用局部散瞳剂后和在手术中注射 Mydrane®时刚好在囊切开术之前的平均瞳孔直径分别为 5.1±0.74mm 和 6.15±1.14mm。在 23 例患者(39%)中使用了额外的药物。在该组中,使用 Mydrane®在术前应用局部散瞳剂后和刚好在囊切开术之前的平均瞳孔直径分别为 4.58±1.06mm 和 5.6±1.26mm。

结论

在真实环境中,在术前瞳孔直径<6mm 的患者中,在白内障手术中眼内注射 Mydrane®后手术期间达到的平均瞳孔直径比术前应用局部散瞳剂后的平均瞳孔直径大 1mm 以上,尽管手术会造成创伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33da/10087216/2e3c8ae7aeea/AOS-101-e81-g004.jpg

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