Repository logo
 
Publication

Systemic exposure to intracameral vs topical mydriatic agents: in cataract surgery

2019Journal article Open access
Simple item page
dc.contributor.authorGuell, J.
dc.contributor.authorBehndig, A.
dc.contributor.authorPleyer, U.
dc.contributor.authorJaulerry, S.
dc.contributor.authorRozot, P.
dc.contributor.authorPisella, P.
dc.contributor.authorRobert, P.
dc.contributor.authorLanzl, I.
dc.contributor.authorPourjavan, S.
dc.contributor.authorAguiar, C.
dc.contributor.authorFernandez, J.
dc.contributor.authorGrabner, G.
dc.contributor.authorMencucci, R.
dc.contributor.authorChiambaretta, F.
dc.contributor.authorLabetoulle, M.
dc.date.accessioned2020-05-06T22:51:35Z
dc.date.available2020-05-06T22:51:35Z
dc.date.issued2019
dc.description.abstractObjective: The objective of this study was to compare systemic exposure to tropicamide/phenylephrine following intracameral or topical administration before cataract surgery. Patients and methods: Mydriatics exposure was calculated in patients randomized to intracameral fixed combination of mydriatics and anesthetic ([ICMA]: tropicamide 0.02%, phenylephrine 0.31%, and lidocaine 1%, N=271) or mydriatic eye drops ([EDs]: tropicamide 0.5% and phenylephrine 10%, N=283). Additional doses were permitted if required. Mydriatic plasma levels were determined by mass spectrometric HPLC in 15 patients per group before and after administration. Results: Most ICMA patients (73.6%) received a single dose (200 µL) representing an exposure to tropicamide of 0.04 mg and phenylephrine of 0.62 mg. None of these patients received additional mydriatics. In the control group (three administrations), the exposure was 0.45 (11.3-fold higher than ICMA) and 10.2 (16.5-fold higher) mg. When additional ED was used in this group (9.2% of patients), it was 37.5-fold higher for tropicamide (10 drops, 1.5 mg) and 54.8-fold higher for phenylephrine (10 drops, 34 mg) than the recommended ICMA dose. Tropicamide plasma levels were not detectable at any time point in ICMA patients while it was detectable in all ED patients at 12 and 30 minutes. Phenylephrine was detectable in 14.3% of ICMA patients compared to all ED patients at least at one time point. More ED patients experienced a meaningful increase in blood pressure and/or heart rate (11.2% vs 6.0% of ICMA patients; P=0.03). Conclusion: Systemic exposure to tropicamide/phenylephrine was lower and cardiovascular (CV) effects were less frequent with ICMA. This could be of particular significance in patients at CV risk.pt_PT
dc.description.sponsorshipThis study was conceived and funded by Laboratoires Théa, Clermont Ferrand, Francept_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationGuell J, Behndig A, Pleyer U, et al. Systemic exposure to intracameral vs topical mydriatic agents: in cataract surgery. Clin Ophthalmol. 2019;13:811‐819. Published 2019 May 3. doi:10.2147/OPTH.S189671pt_PT
dc.identifier.doi10.2147/OPTH.S189671pt_PT
dc.identifier.issn1177-5467
dc.identifier.issn1177-5483
dc.identifier.urihttp://hdl.handle.net/10400.16/2370
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherDove Medical Presspt_PT
dc.relation.publisherversionhttps://www.dovepress.com/systemic-exposure-to-intracameral-vs-topical-mydriatic-agents-in-catar-peer-reviewed-article-OPTHpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectcardiovascular safetypt_PT
dc.subjectcataract surgerypt_PT
dc.subjectintracameral mydriasispt_PT
dc.subjectsystemic influencept_PT
dc.subjecttopical mydriasispt_PT
dc.titleSystemic exposure to intracameral vs topical mydriatic agents: in cataract surgerypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceNew Zealandpt_PT
oaire.citation.endPage819pt_PT
oaire.citation.startPage811pt_PT
oaire.citation.titleClinical ophthalmology (Auckland, N.Z.)pt_PT
oaire.citation.volume13pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Systemic exposure to intracameral.pdf
Size:
504.33 KB
Format:
Adobe Portable Document Format
Download

Collections

SOFT - Artigos publicados em revistas indexadas na Pubmed/Medline