Background: A strong association exists between the use of tamsulosin and the occurance of intraoperative floppy\r\niris syndrome. Several methods were advocated to overcome the progressive intraopertive miosis.\r\nOur purpose was to investigate the effect of a mydriatic-cocktail soaked cellulose sponge on perioperative pupil\r\ndiameter in tamsulosin-treated patients undergoing elective cataract surgery.\r\nMethods: Patients using tamsulosin were dilated either with mydriatic-cocktail soaked sponge (group 1) or with\r\nconventional eyedrop regimen (group 2). Control patients not taking any a1 adrenergic receptor inhibtors were also\r\ndilated with mydriatic sponge (group 3).\r\nIn all groups oxybuprocain 0.4%, cocain 4%, tropicamide 1%, phenylephrine 10%, diclophenac 0.1% along with\r\nchloramphenicol 0.5% were used preoperatively.\r\nPupil diameter (mm) was measured preoperatively, after nucleus delivery, and before IOL implantation. Adverse\r\neffects associated with the use of sponge, minor and major intraoperative complications, the use of iris retractors\r\nand operation time were recorded.\r\nDifferences in general between groups were analyzed with a one way analysis of variance (ANOVA); differences\r\nbetween groups in proportions were assessed by Fisherââ?¬â?¢s exact test.\r\nResults: Mean pupil diameter (mm) was preopertively: 7.52 Ã?± 1.21, 7.30 Ã?± 1.55 and 7.99 Ã?± 0.96 (ANOVA: p = 0.079);\r\nafter nucleus delivery: 6 Ã?± 1.20, 6.29 Ã?± 1.12 and 6.52 Ã?± 0.81 (ANOVA: p = 0.123); before IOL implantation: 5.46 Ã?± 1.06,\r\n5.83 Ã?± 1.09 and 6.17 Ã?± 0.89 (ANOVA: p = 0.0291).\r\nNo adverse effect related to sponge use was detected. Frequency of minor complications, and iris hook use was\r\nsimilar in the two tamsulosin treated group. Operation time did not differ significantly in the three groups.\r\nConclusion: We have found that using a mydriatic cocktail-soaked wick ââ?¬â?? an alternative way to achieve intraoperative\r\nmydriasis for cataract surgery ââ?¬â?? was as effective and safe as the conventional repeated eyedrops regiment for\r\ntamsulosin treated patients.
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