THE EFFECT OF INTRACAMERAL ADRENALINE INFUSION ON PUPIL SIZE, PULSE-RATE, AND BLOOD-PRESSURE DURING PHACOEMULSIFICATION

Pupillary constriction during phacoemulsification (phaco) and irrigati on/aspiration (I/A) is found to be the major cause of iris damage, inc omplete cortex removal, posterior capsule rupture, vitreous loss and e ven posterior lens material dislocation. Cataract surgery is performed more easily if mydriasis can be maintained. Irrigation fluid containi ng adrenaline is thought to be of benefit in this respect. We designed a prospective study assessing the efficacy and safety of using periop erative adrenaline during phacoemulsification, as an adjunct to preope rative topical mydriatics. Forty-two cases were randomized to receive intraocular irrigation fluid with or without 1:1,000,000 adrenaline, a s a study or control group. Diameter of the pupil, pulse rate, systoli c and diastolic pressure before-phaco, after-phaco-before-I/A and afte r-YA were measured. All of the operations were performed by the same s urgeon with the same technique. The pupil size after-phaco-before-I/A was 8.00 mm in the study group and 5.96 mm in the control group. The m ydriasis maintained during phacoemulsification was significantly great er in the study group, p<0.00001. The pupil size after-I/A was 8.03 mm in the study group, and 5.54 mm in the control group. The mydriasis m aintained during I/A was significantly greater in the study group, p<0 .00001. Pulse rate and blood pressure in patients of the study group, even those with hypertension, showed no significant fluctuation during the surgery. We concluded that intraocular irrigation with 1:1,000,00 0 adrenaline was a safe and effective way of maintaining mydriasis dur ing cataract surgery.