Efficacy of intracameral mydriatics in pediatric lens surgery.

IF 2 4区 医学 Q2 OPHTHALMOLOGY Ophthalmic Research Pub Date : 2024-11-01 DOI:10.1159/000542192
Luc Van Os, Kristien Wouters, Hanne Herbots, William Aerts, Catalina Dumitrascu, Iske De Backer, Carine Smitz, Alexander L N van Nuijs, Adrian Covaci, Vera Saldien, Marie-José B R Tassignon
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Abstract

Introduction To evaluate the efficacy of intracameral administration of Mydrane® in children undergoing lens surgery. Methods We set up a single center prospective cohort trial including 40 consecutive patients between 8 weeks and 17 years old who were planned for lens surgery, including cataract, persistent fetal vasculature (PFV) or lens subluxation. We injected 0,1 ml of intracameral Mydrane at the beginning of surgery, no preoperative mydriatic eye drops were used. The aim of the study was to measure pupil size, and to monitor the evolution of the pupil size during surgery and the need for additional pupil expanding techniques. Results In 30 patients (75% (95%CI: 59 - 87%)), we did not need additional manipulations to obtain sufficient pupillary dilatation to perform the surgery and to implant an intraocular lens (IOL) following the bag-in-the-lens (BIL) technique. In the remaining 10 patients (25%), we saw an initiation of dilatation, but not to the required pupil diameter to continue the surgery without additional surgical maneuvers. The duration of surgery was significantly longer in the partial response group, reflecting the need for additional surgical steps. A significant relation between increase of pupillary diameter and age (P = 0.003), gender (P = 0.032) and horizontal corneal diameter (P < 0.001) could be shown. Even at baseline there is a larger pupil diameter in eyes with larger horizontal corneal diameters (p=0.039). No adverse events were observed during this study. Conclusion Intracameral administration of Mydrane resulted in some degree of dilatation in all eyes in this series, 75% of eyes did not need additional techniques to proceed with the surgery. Smaller pupils at baseline, younger age, male sex and small horizontal corneal diameter were related to a poorer response to Mydrane. The mydriasis persisted for the entire duration of the surgery, no ocular adverse events were observed during this study. This leads us to conclude that intracameral Mydrane is an effective and safe way to dilate the pupil in pediatric lens surgery.

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小儿晶状体手术中巩膜内迷幻剂的疗效。
引言 目的 评估在儿童晶状体手术中瞳孔内注射迈达灵®的疗效。方法 我们建立了一个单中心前瞻性队列试验,包括40名8周至17岁的连续患者,他们都计划接受晶状体手术,包括白内障、持续性胎儿血管(PFV)或晶状体半脱位。在手术开始时,我们在巩膜内注射了0.1毫升的迈瑞(Mydrane),术前没有使用眼药水。研究的目的是测量瞳孔大小,监测手术过程中瞳孔大小的变化以及是否需要额外的扩瞳技术。结果 在 30 名患者(75%(95%CI:59 - 87%))中,我们不需要额外的操作来获得足够的瞳孔放大,就能进行手术,并按照镜袋(BIL)技术植入人工晶体(IOL)。其余 10 名患者(25%)的瞳孔开始扩张,但未达到所需的瞳孔直径,因此无需额外的手术操作即可继续手术。部分反应组的手术时间明显更长,这反映出需要额外的手术步骤。瞳孔直径的增大与年龄(P = 0.003)、性别(P = 0.032)和角膜水平直径(P < 0.001)有明显关系。即使在基线时,水平角膜直径较大的眼睛瞳孔直径也较大(P=0.039)。本研究未发现任何不良反应。结论 在本系列研究中,瞳孔内注射米达令后,所有眼睛的瞳孔都有一定程度的放大,75%的眼睛不需要额外的技术就能进行手术。基线瞳孔较小、年龄较小、男性和角膜水平直径较小的患者对迈达林的反应较差。在整个手术过程中,瞳孔散大一直持续,在这项研究中没有观察到眼部不良反应。因此,我们得出结论,在小儿晶状体手术中,瞳孔内注射米屈肼是一种有效而安全的散瞳方法。
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来源期刊
Ophthalmic Research
Ophthalmic Research 医学-眼科学
CiteScore
3.80
自引率
4.80%
发文量
75
审稿时长
6-12 weeks
期刊介绍: ''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.
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