Effect of intracameral epinephrine use on macular thickness after uneventful phacoemulsification

J Cataract Refract Surg. 2010 Aug;36(8):1380-4. doi: 10.1016/j.jcrs.2010.02.020.

Abstract

Purpose: To evaluate changes in central macular thickness using optical coherence tomography after uneventful cataract surgery combined with intracameral epinephrine use.

Setting: Beyoğlu Eye Training and Research Hospital, Istanbul, Turkey.

Methods: This prospective case series comprised eyes of consecutive patients who had uneventful phacoemulsification and in-the-bag intraocular lens (IOL) implantation between August 2005 and January 2006. The eyes were randomly assigned to 1 of 2 groups. In 1 group, 0.2 mL epinephrine (1:5000 solution) was injected just after the clear corneal incision was created. The other group (control) did not receive epinephrine. Optical coherence tomography was performed in all eyes preoperatively as well as postoperatively at 1 day, 1 week, and 1, 3, and 6 months.

Results: The epinephrine group comprised 73 eyes (73 patients) and the control group, 76 eyes (86 patients). In both groups, the increase in retinal thickness from preoperatively to 1, 3, and 6 months postoperatively was statistically significant (P<.05); the difference was not statistically significant at 1 day or 1 week in either group (P>.05). There were no statistically significant differences between the 2 groups in mean retinal thickness throughout the follow-up (P>.05). Clinically significant macular edema occurred in 3 eyes in the epinephrine group and 3 eyes in the control group.

Conclusion: Although epinephrine is a well-known risk factor for central macular edema, intracameral injection of 0.2 mL epinephrine (1:5000) did not increase the risk for central macular edema in eyes with no risk factors that had uneventful phacoemulsification with IOL implantation.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anterior Chamber / drug effects*
  • Epinephrine / administration & dosage*
  • Female
  • Follow-Up Studies
  • Humans
  • Injections
  • Lens Implantation, Intraocular*
  • Macula Lutea / drug effects
  • Macula Lutea / pathology*
  • Macular Edema / chemically induced
  • Macular Edema / diagnosis
  • Male
  • Middle Aged
  • Mydriatics / administration & dosage*
  • Phacoemulsification*
  • Prospective Studies
  • Pupil / drug effects*
  • Tomography, Optical Coherence

Substances

  • Mydriatics
  • Epinephrine