Related Experiment Video
Updated: Jun 23, 2026

Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries
Published on: July 7, 2023
Preoperative topical cyclopentolate can be omitted when using intracameral lidocaine in phacoemulsification surgery
Björn Lundberg1, Anders Behndig
1Department of Clinical Sciences/Ophthalmology, Umeå University Hospital, Umeå, Sweden.
Purpose:
To evaluate the mydriatic effect of topical cyclopentolate 1% when combined with topical phenylephrine 10% and intracameral lidocaine 1% in phacoemulsification cataract surgery.
Methods:
We performed a prospective, double-masked, randomized trial including 20 patients with age-related cataract, who were scheduled for unilateral phacoemulsification and intraocular lens (IOL) implantation. Patients were given either two drops of phenylephrine 10% at 30 mins and 15 mins prior to surgery (group 1), or two drops each of cyclopentolate 1% and phenylephrine 10% at the same time points (group 2). All patients were also given lidocaine 1% intracamerally at the beginning of the procedure. Intraoperative pupil sizes were assessed from video-recordings.
Results:
Initially, pupil sizes were significantly smaller in group 1 (4.8 +/- 1.2 mm versus 6.5 +/- 1.4 mm; p = 0.0098), but the lidocaine injection increased the pupil sizes in group 1 significantly, so that pupil sizes in both groups were equalized throughout the surgical procedure.
Conclusions:
Preoperative topical cyclopentolate does not enhance mydriasis in phacoemulsification surgery when using intracameral lidocaine and can be omitted when intracameral lidocaine is used.
Related Concept Videos
Local Anesthetics: Common Agents and Their Applications
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Ophthalmic Drug Delivery Systems
Angle Closure Glaucoma: Treatment
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
Local Anesthetics: Pharmacokinetics
