Table 2.
Mydriasis as an off-label use of local anesthetics.
| Objective | Intervention | Patients | Technique | Drug and dose | Result | Proposed mechanism | Adverse event | References |
|---|---|---|---|---|---|---|---|---|
| Induce pupil dilation without using preoperative mydriatic eye drops | Phacoemulsification | 12 | Intracameral injection | 0.3–0.5 ml of lidocaine 1% | Akinesia of the iris, mydriasis 5.2–7.2 mm | Anesthesia of all the nerve fibers of the anterior chamber | None | Cionni et al. 59 |
| Evaluate pupil dilation from intracameral injection of lidocaine | Trabeculectomy surgery | 25 | Intracameral injection | 0.2–0.3 ml of lidocaine 1% | Mydriasis (7.21 mm male and 5.96 mm female) | Not mentioned | None | Lee et al. 61 |
| Evaluate pupil dilation by lidocaine | Phacoemulsification | 27 | Intracameral injection | 0.2–0.3 ml of lidocaine 1% | Mydriasis 4.52 ± 0.08 mm | Not mentioned | None | Nikeghbali et al. 60 |
| Quantify the mydriatic and cycloplegic effects from topically applied lidocaine and tetracaine | Double-masked, randomized, intra-individually comparing study | 52 eyes | Topical drops | 3 drops of lidocaine 4% in one eye and contralateral tetracaine 1% every 90 s | Mydriasis (lidocaine: 3.52 ± 0.76 mm; tetracaine: 3.44 ± 0.59 mm) | Blocking constriction of the pupil to the light and paralyze the motor nerves | Changes in corneal epithelium | Behndig 55 |
| Quantify the mydriatic effect and side effects of topical lidocaine with different pH values and concentrations | Intra-individual comparison double-masked randomized study | 10 | Topical drops | Lidocaine (4%, 8% and 16%) | Lidocaine 8%: mydriasis (4.16 ± 0.13 mm) | Not mentioned | Corneal epithelial damage, corneal edema, and reduced vision | Claesson et al. 56 |
| Investigate the effects of sub-Tenon’s capsule ropivacaine injection on pupillary diameter | Strabismus surgery | 16 | Sub-Tenon’s | 2.5–3 ml of a ropivacaine 1% | Mydriasis of 6 mm | Ciliary ganglion block | None | Savino et al. 57 |
| Evaluate pupil dilation with intracameral injection of 1% vs topical eye mydriatic | Phacoemulsification | 20 | Intracameral injection | 0.2 ml of lidocaine 1% | Mydriasis (lidocaine 1%: 6.54; cyclopentolate 1% + tropicamide 1%: 6.67) | Not mentioned | None | Samarai et al. 62 |
| Study the effect of lidocaine to induce mydriasis in patients with type 2 diabetes mellitus | Phacoemulsification | 32 | Intracameral injection | 0.3 ml of lidocaine 1% | Mydriasis 5.2 ± 0.5 mm | Not mentioned | None | Joshi 58 |
AC, anterior chamber; PC, posterior chamber.