effects of infusion and bolus intracameral adrenaline during phacoemulsification on endothelial density and morphology

purpose: to compare the morphology and function of corneal enthothelial cell in early postoperative period after phacoemulsification with infusion or bolus intracameral adrenaline. methods: in this prospective randomized study, 71 eyes of 71 patients scheduled for phacoemulsification were randomly assigned to two groups: one group (31 eyes) received bolus intraocular adrenaline at 1/10,000 concentration and the other group (30 eyes) received adrenaline infusion at 1/1,000,000 concentration intraoperatively. pre- and one month postoperatively, a complete ophthalmologic examination as well as endothelial evaluation with confoscan iii was performed. effective ­­phaco time (ept) and pupillary condition during the surgery were recorded. results: differences between the two groups were not statistically significant in demographic characteristics, lens opacity and ept. endothelial cell density was 2737±321 in the bolus group vs 2742±426 in the infusion group preoperatively (p=0.1). after one month, the rate of cell loss was 7.21% in the infusion group and 8.87% in the bolus group (p= 0.13). pupil diameter was >6 mm in 48% of the infusion group vs 33% of the bolus group (p=0.5). conclusion: adrenaline was safe at the studied concentrations and there was no significant difference between bolus and infusion routes of administration in terms of effects on pupil and endothelial cells.