J Korean Ophthalmol Soc.  2018 Dec;59(12):1137-1141. 10.3341/jkos.2018.59.12.1137.

Intracameral Epinephrine Injection after Phacoemulsification on Pupil Dilation during Phacovitrectomy for Proliferative Diabetic Retinopathy

• Kim S
• Park J
• Shin J
• Lee S

• KMID: 2428685
• DOI: http://doi.org/10.3341/jkos.2018.59.12.1137

Abstract

PURPOSE
We explored the mydriatic effects of injected intracameral epinephrine after phacoemulsification (PE) combined with phacovitrectomy to treat proliferative diabetic retinopathy (PDR).
METHODS
We enrolled 96 patients (96 eyes) who underwent phacovitrectomy to treat PDR; we used ImageJ software to measure pupil sizes and the ratios of pupil to cornea area (PCA) before and after PE and after pars plana vitrectomy (PPV). We compared pupil sizes between those who received intracameral epinephrine (0.001% w/v) after PE but before PPV (study group, 46 eyes) and patients not so treated (control group, 50 eyes).
RESULTS
The PCA ratios of the study group were 0.52 ± 0.11 before PE, 0.43 ± 0.12 after PE, and 0.51 ± 0.11 after PPV, respectively. Changes in pupil size were significant (p < 0.001, p < 0.001 respectively). The PCA ratios of the control group were 0.52 ± 0.10 before PE, 0.39 ± 0.15 after PE, and 0.43 ± 0.15 after PPV, respectively. Changes in pupil size after PE were significant (p = 0.011) but the change after PPV was not (p = 0.056).
CONCLUSIONS
Intracameral epinephrine given after PE but before PPV effectively dilates the pupils during phacovitrectomy to treat PDR.

Keyword

Diabetic retinopathy; Epinephrine; Phacoemulsification; Pupil; Vitrectomy

MeSH Terms

Cornea
Diabetic Retinopathy*
Epinephrine*
Humans
Mydriatics
Passive Cutaneous Anaphylaxis
Phacoemulsification*
Pupil*
Vitrectomy
Epinephrine
Mydriatics

Figure

• 

  Figure 1 The ratio of pupil to cornea area (PCA ratio) at different stages of surgery in the two groups. (A) Intracameral epinephrine injection group, (B) control group. The PCA ratio decreased after cataract surgery in both groups but the PCA ratio increased after pars plana vitrectomy in the injection group. OP = operation; PPV =pars plana vitrectomy. *Statistically significant.

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