A Clinical Study of Efficacy of Intracameral Phenocaine in Phacoemulsification Cataract Surgery

Abstract

Background: Cataract is the biggest cause of curable blindness in India & worldwide. Cataract extraction is the most effective surgical intervention in terms of quality of life restored. Phacoemulsification has led to substantial decrease in duration of surgery, postoperative course and duration of hospitalization. However obtaining adequate, quick, stable mydriasis and anaesthesia is one of the key points influencing the safety of surgery and patients comfort. Mydriatic eyedrops is the standard method for pupil dilatation. An alternative to the traditional preparation for cataract surgery is a complex drug containing mydriatics and analgesics: Phenocaine plus (entod pharma) mixture of 0.2 mg tropicamide, 0.31mg phenylephrine, and 10 mg lidocaine. The present study is undertaken to study efficacy of intracameral mydriasis by phenocaine plus in phacoemulsification cataract surgery. Materials and Methods: Single
centre, prospective observational study was done over a period of 18 months between 1st March 2021 to 31st August 2022. 200 patients underwent phacoemulsification under intracameral phenocaine plus were prospectively evaluated for grade of mydriasis, pain
outcome, clinical outcome and also patients and surgeon satisfaction through questionnaire. Patients with History of previous ocular co morbidities, injury or surgery, who are unable to understand pain scale, Traumatic cataract, congenital cataract, complicated cataract, Patients with Pxf (pseudo exfoliation syndrome) were excluded from the study.

Results: Out of 200 patients 75% of the patients had no unwanted ocular movement whereas in 25% surgeon had some difficulty due to ocular movements. 83.5% of patients achieved excellent mydriasis (> 6 mm), maintained during the course of phacoemulsification surgery without the need of additional mydriatics and anaesthesia. Conclusion: The Intracameral solution of phenocaine plus solution containing 0.2 mg tropicamide, 0.31 mg phenylephrine, and 10mg lidocaine can be effectively used in patients with reduced preparation time, allowing a complete mydriasis management along with ocular analgesia. Intra-op pain score, need for supplemental
anaesthesia and surgeons experience was better.