Vol. 6, Issue 1, Part A (2024)

Objective: To collect expert opinion regarding the prescription pattern and clinical use of intracameral medication tropicamide + phenylephrine + lidocaine during cataract surgery in Indian settings.
Methodology: This cross-sectional study used a 33-item, multiple-choice questionnaire to collect opinions from cataract surgery specialists. The survey covered topics such as current clinical observations, patient preferences, experiences with cataract surgery, and the usage of tropicamide + phenylephrine + lidocaine in combination for the appropriate pupil dilation during cataract surgery. Descriptive statistics were applied to the data analysis.
Results: Among the 212 clinicians surveyed, 44% had 6-15 years of experience in clinical ophthalmology, with about 50% specializing in cataract surgery. Despite the use of preoperative mydriatics, <10% of patients had small pupils (< 5 mm) at the beginning of surgery. The combination of tropicamide + phenylephrine + lidocaine injection was highly favored, with 67% noting no significant learning curve. Approximately 74% of the experts reported that the use of intracameral medication was the fastest technique with minimal impact on surgery time. The combination was considered highly effective by 40% of clinicians, and 50% reported achievement of full pupil dilation in 6-10 seconds. As reported by 41% of the experts, postoperative issues such as pain and discomfort were noted only in 1 out of 5 patients and 74% observed minimal postoperative iritis.
Conclusion: The survey has corroborated the safety and efficacy of combination of tropicamide + phenylephrine + lidocaine injection for achieving optimal pupillary dilation in cataract surgery. Most clinicians reported minimal adverse effects with the combination, with the attainment of rapid and sustained mydriasis.