Safety of the combined use of lidocaine and phenylephrine as intracameral mydriatics in cataract surgery

Abstract

Objective: Evaluate the ocular and systemic safety of a combination of 2% lidocaine and 1% phenylephrine administered intracamerally to achieve intraoperative mydriasis in cataract surgery.
Methods: A prospective study was conducted of a case series of 70 patients (70 eyes) who underwent phacoemulsification with intraocular lens implantation. The intraoperative mydriasis group was composed of 35 patients dilated with an intracameral injection of lidocaine and phenylephrine before surgery, whereas another 35 eyes were dilated by the conventional method, with mydriatic eye drops. Ocular safety evaluation was based on the analysis of a wide variety of pre- and postoperative ophthalmological examination parameters.
Results: Intraocular pressure, central corneal thickness, corneal endothelial cell density and postoperative corneal edema as an anterior segment finding, behaved in a similar manner in both study groups. An intraoperative complication was reported in the conventional method group and a case with postoperative cystoid macular edema in the intraoperative mydriasis group group, neither of them exhibiting significant differences.
Conclusion: Intracameral lidocaine plus phenylephrine injection is a safe ocular and systemic option to achieve mydriasis during phacoemulsification.
Key words: Preoperative mydriasis; intracameral mydriasis; cataract surgery; systemic adverse effects.