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

Sangbum Kim; Jongyeop Park; Jaeryung Shin; Seungwoo Lee

doi:10.3341/jkos.2018.59.12.1137

Journal List > J Korean Ophthalmol Soc > v.59(12) > 1109300

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Kim, Park, Shin, and Lee: Intracameral Epinephrine Injection after Phacoemulsification on Pupil Dilation during Phacovitrectomy for Proliferative Diabetic Retinopathy

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(12): 1137-1141.

Published online: 17 December 2018

DOI: https://doi.org/10.3341/jkos.2018.59.12.1137

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

Sangbum Kim, MD¹, Jongyeop Park, MD², Jaeryung Shin, BS³, Seungwoo Lee, MD¹

¹Department of Ophthalmology, Dongguk University College of Medicine, Gyeongju, Korea.

²Goheung Health Center, Goheung, Korea.

³Dongguk University College of Medicine, Gyeongju, Korea.

Address reprint requests to Seungwoo Lee, MD. Department of Ophthalmology, Dongguk University Gyeongju Hospital, #87 Dongdae-ro, Gyeongju 38067, Korea. Tel: 82-54-770-8256, Fax: 82-54-772-9618, jazzhanul@hanmail.net

Received 19 July 2018 Revised 11 September 2018 Accepted 23 November 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Diabetic retinopathy, Epinephrine, Phacoemulsification, Pupil, Vitrectomy

Figures and Tables

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.

Table 1

Baseline characteristics, best-corrected visual acuity (BCVA) and intraocular pressure (IOP) of the two groups

Values are presented as mean ± standard deviation or number.

^*Paired t-test.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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