We explored the mydriatic effects of injected intracameral epinephrine after phacoemulsification (PE) combined with phacovitrectomy to treat proliferative diabetic retinopathy (PDR).

We enrolled 96 patients (96 eyes) who underwent phacovitrectomy to treat PDR; we used ImageJ software to measure pupil sizes and the ratios of pupil to cornea area (PCA) before and after PE and after pars plana vitrectomy (PPV). We compared pupil sizes between those who received intracameral epinephrine (0.001% w/v) after PE but before PPV (study group, 46 eyes) and patients not so treated (control group, 50 eyes).

The PCA ratios of the study group were 0.52 ± 0.11 before PE, 0.43 ± 0.12 after PE, and 0.51 ± 0.11 after PPV, respectively. Changes in pupil size were significant ( p < 0.001, p < 0.001 respectively). The PCA ratios of the control group were 0.52 ± 0.10 before PE, 0.39 ± 0.15 after PE, and 0.43 ± 0.15 after PPV, respectively. Changes in pupil size after PE were significant ( p = 0.011) but the change after PPV was not ( p = 0.056).

Intracameral epinephrine given after PE but before PPV effectively dilates the pupils during phacovitrectomy to treat PDR.