Comparison between Intracameral Adrenaline Injection in Addition to Topical Mydriatics and Topical Mydriatics only in Phacoemulsification Surgery

Purpose
The aim of the present study was to compare the pupil diameter in cases injected with intracameral adrenaline intraoperatively, in addition to topical mydriatics, and cases that received topical mydriatics only. In addition, this study aimed at assessing the systemic and local side effects of the two techniques.
Patients and methods
The study was conducted on a total of 80 consecutive eyes that underwent phacoemulsification surgery. Patients with different types of cataract requiring phacoemulsification were included in this study. The patients were randomized and divided into two groups. The first group (50 cases) received intraoperative bolus adrenaline injection intracameraly, in addition to preoperative topical mydriatics. The pupil diameter was measured twice, once after topical mydriatics and the second time after intracameral adrenaline injection. The second group (30 cases) received benoxinate hydrochloride 4 mg (Benox) preoperatively as a topical anesthetic, and tropicamid 1% (Mydriacil) as mydriatic. The pupil diameter was measured by using a squint caliper after mydriacyl.
Results
The mean preoperative pupil diameter in the first group was 6.76 ± 0.90 mm. Patients in the first group had smaller pupils. The mean preoperative pupil diameter in the second group was 8.07 ± 0.68 mm. The difference between the two groups was statistically significant. On the other hand, the mean pupil diameter after intracameral adrenaline injection was 7.91 ± 1.01 mm, which was statistically different as adrenaline dilated the pupil.
Conclusion
The present study revealed better pupil dilatation in cases with narrower pupil when injected with intracameral adrenaline than in cases with topical mydriatic only, with no local or systemic side effects.