Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Ophthalmol. 2024 Jul 1;72(7):1017-1020. doi: 10.4103/IJO.IJO_2628_23. Epub 2024 Mar 8.
To study the pupil dynamics with premixed intracameral anesthetic mydriatic combination of phenylephrine (0.31%), tropicamide (0.02%), and lidocaine (1%) in pediatric cataract surgery.
Consecutive children aged ≤12 years planned for cataract surgery were recruited. A commercially available premixed combination of phenylephrine (0.31%), tropicamide (0.02%), and lidocaine (1%) was injected at the beginning of surgery without any topical/infusion drugs for mydriasis. Pupil sizes at various points of surgery were studied.
We recruited 75 patients with a mean age of 24.3 ± 33.4 months (range: 1 month-11 years). Adequate mydriasis with a single injection was achieved in 93.5% (n = 73 eyes of 70 patients) without additional pharmacotherapy or intervention. The mean pupillary diameter increased from 1.8 ± 0.79 to 6.1 ± 1.4 mm after injection (mean change of 4.2 ± 1.25 mm from baseline). The mean variability in pupillary diameter was 0.73 ± 1.3 mm. In five eyes, good dilatation was not possible even after repeat injection.
Fixed-dose premixed intracameral injection is effective in pupil dilatation. It alleviates the need for any topical dilators or additional intraoperative supplementation for pediatric cataract surgery.
研究在儿童白内障手术中使用混合苯肾上腺素（0.31%）、托吡卡胺（0.02%）和利多卡因（1%）的预混房水内麻醉散瞳剂对瞳孔动力学的影响。
连续招募了年龄在 12 岁以下计划行白内障手术的儿童。在手术开始时，使用市售的混合苯肾上腺素（0.31%）、托吡卡胺（0.02%）和利多卡因（1%）预混液进行散瞳，术中无需使用任何局部或滴注药物。研究了手术过程中不同时间点的瞳孔大小。
共招募了 75 例患者，平均年龄为 24.3 ± 33.4 个月（范围：1 个月至 11 岁）。93.5%（n = 73 眼）的患者通过单次注射即可达到充分散瞳，无需额外进行药物治疗或干预。注射后平均瞳孔直径从 1.8 ± 0.79 增加到 6.1 ± 1.4mm（平均变化为 4.2 ± 1.25mm）。瞳孔直径的平均变异性为 0.73 ± 1.3mm。在五例眼中，即使重复注射也无法达到良好的散瞳效果。
固定剂量的预混房水内注射可有效散瞳，减轻了儿童白内障手术中对任何局部散瞳剂或术中额外补充药物的需求。
