Effectiveness of Intracameral Phenylephrine in Achieving Mydriasis and Reducing Complications During Phacoemulsification: A Systematic Review and Meta-Analysis
Por:
Vazquez-Ferreiro P, Carrera-Hueso FJ, Barreiro-Rodriguez L, Diaz-Rey M, Poquet-Jornet JE, Ramon-Barrios MA and Sanjuan-Cervero R
Publicada:
1 dic 2017
Ahead of Print:
3 nov 2017
Resumen:
Purpose: To compare the effectiveness of intracameral phenylephrine and
topical mydriatics in achieving mydriasis and protecting against
complications during phacoemulsification. Methods: A systematic search
of the literature comparing the mydriatic effect and surgical safety
profile of intracameral phenylephrine and topical mydriatics in
phacoemulsification was conducted in the Medline, Embase, Lilacs, Web of
Science, Cochrane, ClinicalTrials.gov, and Teseo databases. The search
targeted clinical trials, cohort studies, and case-control studies
published between April 20, 2003 and August 14, 2016. Mydriatic effect
was assessed by difference in means in pupil of all the patients in the
studies [mean difference (MD)] and intraoperative complications were
assessed by using inverse-variance weighted odds ratios (ORs), with
adjustment for dose. A meta-regression analysis was also conducted, with
adjustment for dose, use of epinephrine, tamsulosin use, and type of
surgery and type of intraocular lens. Results: We found 7 articles about
mydriatic effect and another 7 about complications. Intracameral
phenylephrine achieved a similar mydriatic effect to topical mydriatics,
with a difference of less than 10% (MD -0.74mm, 95% CI: -1.67 to 0.18,
I-2=95.8%, P<0.0001). The pooled OR for complications was OR 0.50, 95%
CI: 0.19-1.31, I-2=0.0%, P=0.670, and posterior capsular rupture was the
most common complication in the different studies analyzed. Conclusion:
Intracameral phenylephrine achieves a similar mydriatic effect to
topical mydriatics (difference <15%) and is associated with a
not-significant effect on reducing the odds of intraoperative
complications.
Filiaciones:
Vazquez-Ferreiro P:
1 Ophthalmologic Department, Hospital Virxen da Xunqueira , Cee, A Coruna, Spain
2 Social Pharmacy Department, University of Granada , Granada, Spain
:
3 Pharmacy Department, Hospital Dr. Moliner , Serra, Valencia, Spain
Barreiro-Rodriguez L:
1 Ophthalmologic Department, Hospital Virxen da Xunqueira , Cee, A Coruna, Spain
Diaz-Rey M:
1 Ophthalmologic Department, Hospital Virxen da Xunqueira , Cee, A Coruna, Spain
Poquet-Jornet JE:
4 Pharmacy Department, Hospital de Denia , Denia, Alicante, Spain
:
5 Pharmacy Department, Hospital Dr. Peset , Valencia, Spain
Sanjuan-Cervero R:
2 Social Pharmacy Department, University of Granada , Granada, Spain
6 Traumatology Department, Hospital de Denia Marina Salud , Denia, Alicante, Spain
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