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Related Experiment Video

Updated: Jul 20, 2026

Assessing Pupil-linked Changes in Locus Coeruleus-mediated Arousal Elicited by Trigeminal Stimulation

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Pupil dilation using a pledget sponge: a randomized controlled trial.

Austin McCormick¹, Sathish Srinivasan, Shabbir Harun

¹Department of Ophthalmology, Arrowe Park Hospital, Wirral, Merseyside, UK. amccormick@slingshot.co.nz

Clinical & Experimental Ophthalmology

|August 24, 2006

Summary

A cellulose sponge pledget soaked in mydriatics is as effective as eye drops for cataract surgery. This method provides adequate mydriasis without adverse effects, offering a viable alternative for pre-operative pupil dilation.

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Published on: July 4, 2018

Area of Science:

Ophthalmology
Surgical Procedures
Pharmacology

Background:

Cataract surgery requires adequate pupil dilation (mydriasis) for optimal visualization.
Conventional mydriasis induction involves repeated topical administration of eye drops.
An alternative method using a drug-infused pledget in the conjunctival fornix was investigated.

Purpose of the Study:

To compare the efficacy of a mydriatic-soaked pledget versus traditional eye drops for achieving mydriasis.
To assess patient comfort and identify any adverse effects associated with the pledget method.

Main Methods:

A randomized, masked, controlled trial involving 56 patients undergoing cataract surgery.
One group received mydriatics via a cellulose sponge pledget in the lower fornix for 20 minutes.
The control group received standard topical mydriatic eye drops (tropicamide, phenylepherine, atropine).
Pupil diameter was measured photographically; patient stinging was assessed on a 0-10 scale.

Main Results:

No complications were reported in either group.
Mean pupil diameter was comparable between the pledget group (7.44 mm) and the eye drop group (7.23 mm).
Statistical analysis showed no significant difference in pupil diameter (P=0.43) or stinging scores (P=0.69) between the groups.

Conclusions:

A cellulose sponge pledget is a safe and effective alternative to eye drops for mydriasis induction prior to cataract surgery.
The pledget method offers comparable efficacy to conventional drops without increased adverse effects.
This technique provides a potentially more convenient and consistent method for pre-operative pupil dilation.