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Master Thesis

Comparaison intra individuelle de la dilatation pupillaire par une solution intracamérulaire standardisée combinée de mydriatiques (Mydrane®) en peropératoire versus un insert ophtalmique (Mydriasert®) en préopératoire dans la chirurgie de la cataracte standard de patients non diabétiques

Abstract : Introduction: Cataract surgery is the most commonly performed surgery in the world and its success is partly assured by the quality of its mydriasis. Purpose : Compare the pupillary dilation obtained with Mydrane® (standardised intra-cameral solution combined with 0.02% tropicamide, 0.31% phenylephrine, 1% lidocaine) peroperatively versus that of Mydriasert® (0.28 mg tropicamide insert, 5.4 mg phenylephrine) with a contact time between 45 and 60 min preoperatively of the same eye. Methods: Single-centric prospective study from November 2016 to January 2018 at the Laveran Army Instructional Hospital in Marseille. Patients referred for surgery were dilated in preoperative consultation with Mydriasert®. The pupillary diameter after 45-60 min of contact with the insert was measured manually in the iris image tab of the Pentacam® elevation topograph by two different examiners. Patients were dilated on the day of their cataract surgery with 0.2 cc of Mydrane® injected in the anterior chamber via paracentesis. Thirty seconds later, without viscous addition, an eye photograph was taken by screen capture. The pupillary diameter was evaluated by two different examiners thanks to the Piximeter 5.9 metrology software. The pupil dilation difference obtained by Mydriasert® and Mydrane® was tested by the paired series student t-test. Results: 111 eyes of 82 patients were included. On average, Mydriasert® allowed a pupillary dilation of 7.21 ± 0.79 mm. Mydriasis averaged 6.35 ± 0.8 mm with Mydrane®. This difference of 0.86 mm 95% CI [-0.97; -0.74] was statistically significant (p <0.001). Conclusion: On average, Mydrane® dilates the pupil less well than Mydriasert®. The mydriasis obtained with Mydrane® however remains comfortable for the realization of capsulorhexis. And it brings a preoperative time saving as well as an anesthetic supplement to cataract surgery. Nevertheless, the use of Mydriasert® is relevant when large size mydriasis is required.
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https://dumas.ccsd.cnrs.fr/dumas-02615197
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Submitted on : Friday, May 22, 2020 - 11:35:37 AM
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Alexandra de Faria. Comparaison intra individuelle de la dilatation pupillaire par une solution intracamérulaire standardisée combinée de mydriatiques (Mydrane®) en peropératoire versus un insert ophtalmique (Mydriasert®) en préopératoire dans la chirurgie de la cataracte standard de patients non diabétiques. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02615197⟩

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