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Year : 2021  |  Volume : 33  |  Issue : 3  |  Page : 311-315

Comparative study of intracameral lidocaine and topical mydriatics in pupil dilation during phacoemulsification

Department of Ophthalmology, Government Medical College, Kannur, Kerala, India

Correspondence Address:
Dr. K K Shilpa Sunil
Department of Ophthalmology, Government Medical College, Pariyaram, Kannur - 670 503, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/kjo.kjo_74_21

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Introduction: Intracameral injection of preservative-free lidocaine is used as an alternative to reduce the potential disadvantages of common mydriatics in cataract surgery. Aims and Objectives: The aim is to evaluate pupil dilation by an intracameral injection of lidocaine during phacoemulsification cataract surgery and compare the results with those using conventional topical mydriatics. Methods: A prospective cohort study was conducted in 60 consecutive patients undergoing phacoemulsification cataract surgery under topical anesthesia at Government Medical College, Kannur from July 2018 to December 2019. Patients were allocated to intracameral lidocaine or topical mydriatics for dilation of the pupil before phacoemulsification. Results: The preoperative pupil size was similar in intracameral lidocaine (2.90 ± 0.3 mm) and topical mydriatic (2.81 ± 0.4 mm) groups. Pupil dilation was slightly more in the topical mydriatic group (7.31 ± 1.0 mm) compared to the intracameral lidocaine group (6.96 ± 1.0 mm). The pupil size at the end of the surgery was nearly similar in both groups. Mean duration of the surgery was similar in both the groups. Both the groups had 27 patients who maintained dilation till the end of the surgery. The difference between the groups was not statistically significant and a post hoc power analysis showed the need for studies with a larger sample size. Conclusion: This study shows that injection of 0.2–0.3 ml of preservative-free lidocaine 1% intracamerally provides persistent, stable, satisfactory pupil dilation comparable to that of topical mydriatics, for safe phacoemulsification, and intraocular lens implantation. However, studies with a larger sample size are needed to confirm that both interventions perform similarly.

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