Ibopamine: a new preoperative mydriatic for cataract surgery

Ibopamine is a dopaminergic mydriatic of proven use for fundoscopy. This double-blind prospective trial assessed its efficacy and safety as a preoperative mydriatic agent. 105 patients undergoing extracapsular cataract surgery were randomly allocated to receive Ibopamine 1%, Ibopamine 1% with Cyclopentolate 1%, or the control Phenylephrine 10% with Cyclopentolate 1%. Ibopamine alone achieved good mydriasis prior to anaesthesia, but this was not maintained intraoperatively. Cyclopentolate combined with Ibopamine, produced consistently greater mydriasis than when combined with Phenylephrine, but the difference became less marked as surgery continued. Analysis in relation to the stage of surgery showed that the greatest stimulus to miosis occurred during expression of the nucleus. Pulse rate and blood pressure in the 51 local anaesthetic cases showed no significant difference between the treatment groups, and there was no significant variation from baseline. The incidence of local side effects was similar in the three groups, and there were no systemic symptoms attributable to the drops. In conclusion, Ibopamine is a safe and effective mydriatic agent for cataract surgery, when used in combination with Cyclopentolate.