Comparing the efficacy of mydriatic cocktail-soaked sponge and conventional pupil dilation in patients using tamsulosin – a randomized controlled trial

BMC Ophthalmology

Research Article

Søren Lundbye-Christensen¹  Henrik Vorum²  László Vezendi³  Finn Eisgart³  Jørgen Vigstrup³  János Hargitai³  Bálint Hargitai⁴ 

[1] Department of Cardiology, Aalborg University, Aalborg, Denmark;Department of Ophthalmology, Aalborg University, Aalborg, Denmark;Department of Ophthalmology, Thy-Mors Hospital, Højtoftevej 2, 7700, Thisted, Denmark;UK Specialist Hospitals, Emersons Green NHS Treatment Center, Bristol, UK;

关键词: Pupil dilation;    Intraoperative floppy iris syndrome;    Tamsulosin;   

DOI  :  10.1186/1471-2415-13-83

 received in 2012-12-07, accepted in 2013-12-16,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundA strong association exists between the use of tamsulosin and the occurance of intraoperative floppy iris syndrome. Several methods were advocated to overcome the progressive intraopertive miosis.Our purpose was to investigate the effect of a mydriatic-cocktail soaked cellulose sponge on perioperative pupil diameter in tamsulosin-treated patients undergoing elective cataract surgery.MethodsPatients using tamsulosin were dilated either with mydriatic-cocktail soaked sponge (group 1) or with conventional eyedrop regimen (group 2). Control patients not taking any α1 adrenergic receptor inhibtors were also dilated with mydriatic sponge (group 3).In all groups oxybuprocain 0.4%, cocain 4%, tropicamide 1%, phenylephrine 10%, diclophenac 0.1% along with chloramphenicol 0.5% were used preoperatively.Pupil diameter (mm) was measured preoperatively, after nucleus delivery, and before IOL implantation. Adverse effects associated with the use of sponge, minor and major intraoperative complications, the use of iris retractors and operation time were recorded.Differences in general between groups were analyzed with a one way analysis of variance (ANOVA); differences between groups in proportions were assessed by Fisher’s exact test.ResultsMean pupil diameter (mm) was preopertively: 7.52 ± 1.21, 7.30 ± 1.55 and 7.99 ± 0.96 (ANOVA: p = 0.079); after nucleus delivery: 6 ± 1.20, 6.29 ± 1.12 and 6.52 ± 0.81 (ANOVA: p = 0.123); before IOL implantation: 5.46 ± 1.06, 5.83 ± 1.09 and 6.17 ± 0.89 (ANOVA: p = 0.0291).No adverse effect related to sponge use was detected. Frequency of minor complications, and iris hook use was similar in the two tamsulosin treated group. Operation time did not differ significantly in the three groups.ConclusionWe have found that using a mydriatic cocktail-soaked wick – an alternative way to achieve intraoperative mydriasis for cataract surgery – was as effective and safe as the conventional repeated eyedrops regiment for tamsulosin treated patients.Trial registrationCurrent Controlled Trials ISRCTN37834752

【 授权许可】

CC BY   
© Hargitai et al.; licensee BioMed Central Ltd. 2013