Dereń-Szumełda Joanna Katarzyna, Dorecka Mariola, Zandecki Łukasz, Mrukwa-Kominek Ewa
Military Institute of Aviation Medicine, Krasińskiego 54/56, 01-755 Warszawa, Poland.
Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-514 Katowice, Poland.
Life (Basel). 2023 Dec 21;14(1):14. doi: 10.3390/life14010014.
To examine the effectiveness of a standardized combination of intracameral mydriatics and anesthetic (SCIMA) on mydriasis in patients with coexisting diseases such as diabetes mellitus (DM) and pseudoexfoliation syndrome (PXF) during phacoemulsification.
Patients with cataract were included in the study if they achieved pupil dilation diameter ≥ 6.0 mm after the administration of mydriatic eyedrops (ME) during the first visit (V1). During the second visit (V2), pupil size measurements were obtained for phacoemulsification surgery with SCIMA. Effective mydriasis was defined as a pupil diameter ≥ 6.0 mm just prior to capsulorhexis without the use of additional pupil dilating agents. The measurements after ME administration during V1 and after SCIMA use during V2 were compared.
103 patients (103 eyes) were divided into 3 groups: cataract and DM ( = 35), cataract and PXF ( = 32), and cataract without DM or PXF ( = 36). SCIMA administration allowed the achievement of effective mydriasis (≥6.0 mm) in all groups ( = 103; 100%). Mydriasis was significantly larger ( ≤ 0.001) after ME (7.3 mm) than after SCIMA (6.8 mm) administration.
Patients with cataract and such comorbidities as DM or PXF are likely to achieve effective pharmacological mydriasis during cataract phacoemulsification after SCIMA application. Mydriasis after ME is slower and larger, while SCIMA is faster.
探讨前房内散瞳剂与麻醉剂标准化组合（SCIMA）在白内障超声乳化术中对合并糖尿病（DM）和假性剥脱综合征（PXF）等疾病患者散瞳的有效性。
如果白内障患者在首次就诊（V1）时使用散瞳眼药水（ME）后瞳孔扩张直径≥6.0mm，则纳入本研究。在第二次就诊（V2）时，使用SCIMA进行超声乳化手术时测量瞳孔大小。有效散瞳定义为在撕囊前不使用额外散瞳剂时瞳孔直径≥6.0mm。比较V1时ME给药后和V2时SCIMA使用后的测量结果。
103例患者（103只眼）分为3组：白内障合并DM（n = 35）、白内障合并PXF（n = 32）和无DM或PXF的白内障（n = 36）。所有组（n = 103；100%）使用SCIMA后均实现了有效散瞳（≥6.0mm）。ME给药后散瞳（7.3mm）明显大于SCIMA给药后散瞳（6.8mm）（P≤0.001）。
白内障合并DM或PXF等合并症的患者在应用SCIMA后，白内障超声乳化术中可能实现有效的药物散瞳。ME后的散瞳较慢且程度较大，而SCIMA较快。
