Corneal Endothelial Cell Density and Morphology Following Bolus versus Infusion Intracameral Adrenaline during Phacoemulsification

PURPOSE: To compare early postoperative corneal endothelial cell density and morphology after phacoemulsification using bolus versus infusion intracameral adrenaline. METHODS: In this randomized clinical trial, 71 eyes of 71 patients scheduled for phaco-emulsification were randomly assigned to two groups: one group (31 eyes) received bolus intracameral adrenaline (1:10,000) and the other group (30 eyes) received adrenaline infusion (1:1,000,000). Pre- and one month postoperatively, a complete ophthalmologic examination as well as endothelial evaluation using ConfoScan III was performed; effective phaco time (EPT) and mydriasis during surgery were also compared between the study groups. RESULTS: The two study groups were not significantly different in terms of demographic characteristics, lens opacity and EPT. Endothelial cell density was 2737±321 cell/mm2 in the bolus group vs 2742±426 cell/mm2 in the infusion group preoperatively (P=0.1). One month postoperatively, the rate of cell loss was 7.21% in the infusion group versus 8.87% in the bolus group (P= 0.13). Pupil diameter was > 6 mm in 48% of eyes in the infusion group vs 33% of eyes in the bolus group (P=0.5). CONCLUSION: Adrenaline was safe at the studied concentrations and there was no significant difference between bolus and infusion routes of administration in terms of pupil dilation and endothelial cell loss.