Abstract
Purpose :
Intraoperative intraocular bleeding can present a major challenge in anterior segment surgery such as cataract extraction and glaucoma procedures. The purpose of this prospective case series is to investigate the efficacy of intracameral phenylephrine for controlling intraoperative intraocular bleeding.
Methods :
Intracameral injection of 0.3ml phenylephrine 2.5% (Bauch & Lomb Minims, undiluted) was used in three consecutive prospective cases of intraocular bleeding during cataract surgery, one of which was combined with CyPass® Micro-Stent insertion. All three cases had uncontrolled bleeding despite multiple attempts of irrigation and aspiration of aqueous fluid. The primary outcome measure was halting intraoperative macroscopic bleeding into anterior chamber of the eye following injection. The secondary outcome measure was prevention of post-operative hyphema.
Results :
Complete cessation of intraocular bleeding occurred in all three eyes of patients who had intracameral phenylephrine within one minute of injection. No intaoperative re-bleeding was observed in any case enabling safe completion of surgery. No post-operative hyphema was noted in any of the three patients at all post-operative visits suggesting that microscopic bleeding had also been controlled.
Conclusions :
Intracameral phenylephrine can be used intraoperatively to arrest intraocular bleeding during anterior segment surgery. It is presumed that vasoconstriction enables bleeding vessel coagulation to occur. This technique may be particularly helpful with the rising trend of cataract surgery combined with minimally invasive glaucoma shunt insertion.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.