Paolo Nucci1, Andrea Lembo2, Roberto Caputo3, Andrea Dellavalle1, Massimiliano Serafino4, Irene Schiavetti5, Francesco Pichi6. 1. Department of Clinical Sciences and Community Health, University Eye Clinic, San Giuseppe Hospital-Multimedica, University of Milan, Via San Vittore 12, 20123, Milan, Italy. 2. Department of Clinical Sciences and Community Health, University Eye Clinic, San Giuseppe Hospital-Multimedica, University of Milan, Via San Vittore 12, 20123, Milan, Italy. andrealembo1984@hotmail.com. 3. Department of Pediatric Ophthalmology, Anna Meyer Children's University Hospital, Florence, Italy. 4. Department of Neuroscience, Unit of Ophthalmology, IRCCS Istituto Giannina Gaslini, Genoa, Italy. 5. Department of Health Sciences, University of Genoa, Genoa, Italy. 6. Cleveland Clinic Abu Dhabi, Eye Institute, Abu Dhabi, United Arab Emirates.
Abstract
BACKGROUND: To demonstrate the safety and efficacy of the intracameral use of tropicamide 0.02%/phenylephrine 0.31%/lidocaine 1% in pediatric cataract surgery, a combination widely used in adult patients but still off-label in children. METHODS: Design: two-center, prospective, observational study. SETTING: San Giuseppe Hospital, Milan and Meyer Children's Hospital, Florence. STUDY POPULATION: children from 0 to 4 years of age undergoing cataract surgery with or without intraocular IOL implantation, in the absence of clinically significant systemic conditions, history of ocular surgery, concurrent ocular medication, hypersensitivity to any of the substances and post-traumatic cataracts. During the surgery, patients received the combination drug after the primary access to the anterior chamber. Efficacy was evaluated by achieving an adequate mydriasis in order to perform capsulorhexis, while safety was assessed by recording vital signs (heart rate, blood pressure, respiratory rate, temperature) pre- and post-administration of the substance. RESULTS: This study included 53 surgical procedures of 36 patients: 41 eyes were left aphakic, while 12 eyes received primary IOL implantation. The pupil size was adequate to safely perform capsulorhexis in 52 procedures of 53. The difference in pupil enlargement was significant (6.0 ± 1.14 mm, P = < 0.001). There were no notable changes in vital parameters. CONCLUSIONS: The administration of intracameral tropicamide 0.02%/phenylephrine 0.31%/lidocaine 1% in pediatric cataract surgery is effective for obtaining an adequate mydriasis without any vital parameters changes throughout the procedure.
BACKGROUND: To demonstrate the safety and efficacy of the intracameral use of tropicamide 0.02%/phenylephrine 0.31%/lidocaine 1% in pediatric cataract surgery, a combination widely used in adult patients but still off-label in children. METHODS: Design: two-center, prospective, observational study. SETTING: San Giuseppe Hospital, Milan and Meyer Children's Hospital, Florence. STUDY POPULATION: children from 0 to 4 years of age undergoing cataract surgery with or without intraocular IOL implantation, in the absence of clinically significant systemic conditions, history of ocular surgery, concurrent ocular medication, hypersensitivity to any of the substances and post-traumatic cataracts. During the surgery, patients received the combination drug after the primary access to the anterior chamber. Efficacy was evaluated by achieving an adequate mydriasis in order to perform capsulorhexis, while safety was assessed by recording vital signs (heart rate, blood pressure, respiratory rate, temperature) pre- and post-administration of the substance. RESULTS: This study included 53 surgical procedures of 36 patients: 41 eyes were left aphakic, while 12 eyes received primary IOL implantation. The pupil size was adequate to safely perform capsulorhexis in 52 procedures of 53. The difference in pupil enlargement was significant (6.0 ± 1.14 mm, P = < 0.001). There were no notable changes in vital parameters. CONCLUSIONS: The administration of intracameral tropicamide 0.02%/phenylephrine 0.31%/lidocaine 1% in pediatric cataract surgery is effective for obtaining an adequate mydriasis without any vital parameters changes throughout the procedure.
Authors: Massimiliano Serafino; Rupal H Trivedi; Alex V Levin; M Edward Wilson; Paolo Nucci; Scott R Lambert; Ken K Nischal; David A Plager; Dominique Bremond-Gignac; Ramesh Kekunnaya; Sachiko Nishina; Nasrin N Tehrani; Marcelo C Ventura Journal: Br J Ophthalmol Date: 2015-09-29 Impact factor: 4.638
Authors: David A Plager; Michael J Lynn; Edward G Buckley; M Edward Wilson; Scott R Lambert Journal: Ophthalmology Date: 2011-09-16 Impact factor: 12.079
Authors: Matthew A Cantrell; Heather R Bream-Rouwenhorst; Andrew Steffensmeier; Phyllis Hemerson; Meaghan Rogers; Benton Stamper Journal: Ann Pharmacother Date: 2008-03-25 Impact factor: 3.154