Epi-Shugarcaine provides better intracameral dilation for cataract surgery than LB solution

Researchers prospectively selected 42 patient scheduled for cataract surgery in both eyes. One eye in each patient was randomized to receive either Lundberg and Behndig’s intracameral dilation solution (cyclopentolate 0.1%, phenylephrine 1.5%, and lidocaine 1%) (LB) or epi-Shugarcaine solution (epinephrine 0.025% and lidocaine 0.75% in fortified balanced salt solution [BSS Plus]) (epi-S) intracamerally at the time of cataract surgery. The patients’ second eye received the alternative solution. Each eye received one drop of tropicamide 1% at least 20 minutes before the start of surgery.

Pupil measurements were made before the incision was created, one minute after intracameral solution injection, after the anterior chamber was filled with an ophthalmic viscosurgical device, and at the conclusion of the case. At each time point after instillation, the pupil was statistically significantly larger with epi-S solution than with LB solution, averaging 0.528 mm larger one minute after instillation (mean 7.183 versus 6.665 mm) to 0.34 mm larger (mean 7.381 versus 7.040 mm) by the end of the case. Pupil size was objectively graded via software operated by a video technician who was masked to the solution used.

When combined with one drop of tropicamide 1% preoperatively, both formulations provided safe and effective intracameral dilation for cataract surgery; however, the epi-S solution was the more efficacious at each step of the procedure. Epi-S also allows for clearer corneas than with traditional regimens. The authors added that the epi-S method also offers the advantage of easier availability and less cost than the LB solution.