Purpose  To study the the pattern of intraocular pressure (IOP) change postoperatively with intracamerally injected N-methyl-3, 4-dihydroxyphenylamine (epinephrine) without conventional topical mydriatics in phacoemulsification.
Methods   This prospective randomized study included 48 patients (66eyes) who were given topical mydriatics (33 eyes) or intracameral epinephrine hydrochloride (33 eyes) to dilate the pupil for phacoemulsification and intraocular lens implantation. The topical group received 3 drops of a mixture of tropicamide 0.5% and epinephrine hydrochloride 0.5% given 5minutes apart starting 60 minutes before surgery. The intracameral group received 1ml epinephrine hydrochloride 0.001% for 60s after cornea incision. The IOP was measured preoperatively and 2 hours, 1 day, 1 week and 1 month postoperatively. The IOP readings were statistically analyzed using the student- t test.
Results  The preoperative and postoperative IOPs were (14.62±3.00) mmHg and (17.80±6.02, 15.52±4.86, 13.41±2.71, 12.82±2.92) mmHg in the intracameral group, whereas (13.90±2.79) mmHg and (17.11±5.05, 14.32±4.41, 12.96±2.71, 12.14±3.21) mmHg in the topical group. There was no difference in IOPs between groups (P>.05).
Conclusion  The results show intracamerally injected epinephrine is as safe as conventional topical mydriatics in phacoemulsification.