Dereń-Szumełda Joanna, Dorecka Mariola, Dereń Mirosław, Mrukwa-Kominek Ewa
Ophthalmology Clinic, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland.
University Clinical Centre named after Prof. K. Gibiński, Medical University of Silesia, 40-514 Katowice, Poland.
Life (Basel). 2025 Jan 17;15(1):119. doi: 10.3390/life15010119.
This study aimed to evaluate mydriasis stability during cataract surgery in patients with systemic comorbidities such as diabetes mellitus (DM) and pseudoexfoliation syndrome (PXF) after a standardised combination of intracameral mydriatics and anaesthetic (SCIMA). Stable mydriasis is crucial for safe and effective phacoemulsification.
Patients were included if they achieved pupil dilation ≥6.0 mm during the qualifying visit. A total of 103 patients were enrolled, divided into three groups: cataract with diabetes (C + DM group, = 35), cataract with PXF (C + PXF group, = 32), and cataract without those comorbidities (C group, = 36). SCIMA was administered, and pupil diameters were measured at key surgical stages. Stability was defined as a pupil diameter of ≥6.0 mm without additional pharmacological intervention and no significant change in its diameter (≥3.0 mm).
Stable mydriasis was achieved in 90.3% of patients: 97.1% in the C + DM group, 90.6% in the C + PXF group, and 83.3% in the C group, with no statistically significant differences ( = 0.14).
SCIMA effectively maintains mydriasis stability during cataract surgery, even in patients with systemic comorbidities, ensuring greater surgical safety.
本研究旨在评估在采用前房内散瞳剂与麻醉剂标准化联合方案（SCIMA）后，患有糖尿病（DM）和假性剥脱综合征（PXF）等全身性合并症的患者在白内障手术期间瞳孔散大的稳定性。稳定的瞳孔散大对于安全有效的超声乳化手术至关重要。
如果患者在资格访视期间瞳孔散大至≥6.0毫米，则纳入研究。共招募了103例患者，分为三组：糖尿病性白内障组（C + DM组，n = 35）、假性剥脱性白内障组（C + PXF组，n = 32）和无这些合并症的白内障组（C组，n = 36）。给予SCIMA，并在关键手术阶段测量瞳孔直径。稳定性定义为无需额外药物干预且瞳孔直径≥6.0毫米且直径无显著变化（≥3.0毫米）。
90.3%的患者实现了瞳孔散大稳定：C + DM组为97.1%，C + PXF组为90.6%，C组为83.3%，差异无统计学意义（P = 0.14）。
SCIMA在白内障手术期间能有效维持瞳孔散大稳定性，即使是患有全身性合并症的患者，从而确保更高的手术安全性。
