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

Purpose: To compare early postoperative corneal endothelial cell density and morphologyafter phacoemulsification using bolus versus infusion intracameral adrenaline.Methods: In this randomized clinical trial, 71 eyes of 71 patients scheduled for phacoemulsificationwere randomly assigned to two groups: one group (31 eyes) receivedbolus intracameral adrenaline (1:10,000) and the other group (30 eyes) received adrenalineinfusion (1:1,000,000). Pre- and one month postoperatively, a complete ophthalmologicexamination 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 inthe 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 versus8.87% in the bolus group (P= 0.13). Pupil diameter was 6 mm in 48% of eyes in theinfusion 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 pupildilation and endothelial cell loss.