April 2020

ASCRS NEWS

Pupil expansion device use and operative outcomes with topical dilation versus intracameral epinephrine in resident-performed cataract surgery


by Caroline Wilson, MD, Lauren Hock, MD, Thomas Oetting, MD, Sean Kennedy, BS, Daniel Terveen, MD

J Cataract Refract Surg. 2020;46(4):562–566.
Purpose: To compare the use of topical dilation drops versus topical drops with the addition of intracameral epinephrine in resident-performed cataract surgery and the effects on pupil expansion device (PED) use, surgical costs, and surgical times.
Setting: Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Design: Retrospective chart review
Methods: Resident-performed primary cataract surgical cases using topical dilation drops only or drops with the addition of intracameral epinephrine were analyzed for PED use, surgical time, and costs in all patients and in patients with history of tamsulosin.
Results: In the topical group, PEDs were used in 31.1% cases compared to 13.5% cases in the intracameral group (p<0.0001). History of tamsulosin use was noted in about a third of cases in both groups. For patients with history of tamsulosin use, PED use decreased from 52.7% in the topical cases to 17.9% in the intracameral group (p<0.0001). Average surgical case times were on average 7.1 minutes slower with PED use than without PED use. There was a medication savings of $50.44 per case in the intracameral group compared to the topical group. Factoring in the $100–130 per PED used, total surgical costs were $19,267 less in the intracameral group over 6 months.
Conclusion: Intracameral epinephrine with lidocaine decreases the need for pupil expansion device use during cataract surgery, lowers intraoperative costs, and improves efficiency compared to topical dilation drops alone.

Pupil expansion device use and operative outcomes with topical dilation versus intracameral epinephrine in resident-performed cataract surgery Pupil expansion device use and operative outcomes with topical dilation versus intracameral epinephrine in
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2020-04-13T13:24:06Z
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