Pre-operative minimal-cycloplegia mydriasis for capsulorrhexis in hypermature intumescent cataract

Conventionally adrenergic-anticholinergic combination eye drops (e.g., phenylephrine-tropicamide) are used for pre-operative pupillary dilatation in cataract surgery. This achieves synergy dilatation, but anticholinergic-induced cycloplegia makes already tense lens-capsule of intumescent more taut, and completion capsulorrhexis becomes difficult, often resulting Argentanian flag sign, peripheral extension. An alternative mydriasis-without-cycloplegia strategy (phenylephrine) is also tried better maintenance mydriasis it’s capsule-slackening effect was not thought of. Making best both, we practice a ‘minimal-cycloplegia mydriasis’ approach (MCM) comprising 0.25% tropicamide 5% phenylephrine, instilled succession. study planned to compare our MCM regimen with the conventional fixed-dose-combination 0.8% phenylephrine (Standard). To ease smoothness relative incidence complications, hypermature surgery, between ocular instillation ‘MCM’ traditional ‘Standard’ regimen. The prospective observational 2-arm comparison design. commenced due approval Institutional Ethics Committee. Sixty-one (61) patients (age range: 42-72yrs, number Male: Female 19:42) undergoing surgery by standard SICS+IOL technique whom either two regimens, or were papillary observed. Outcome analysis done Fisher’s Exact Test. Out total 61 cases, 29 received regime 32 cycloplegic dilator. Difference groups statistically non-significant. Frequency completed rhexis attainment post-operative BCVA 6/12 higher regime: p< 0.001 0.0005 respectively. Anterior chamber reactions on first day frequent (p<0.01), transient cleared totally week. Minimal-cycloplegia succession may be preferred cataract.