Intracameral Phenylephrine to Arrest Intraoperative Intraocular Bleeding: A New Technique

Ophthalmol Ther. 2019 Mar;8(1):137-141. doi: 10.1007/s40123-019-0165-y. Epub 2019 Feb 15.

Abstract

Intraoperative intraocular bleeding can present a major challenge during anterior segment operations, such as cataract and glaucoma surgery. In the presence of significant intraocular bleeding, the surgeon may be unable to proceed if the bleeding cannot be controlled. Uncontrolled bleeding may also result in intraoperative or postoperative complications. Intracameral injection of phenylephrine was used in three consecutive cases of intraoperative anterior chamber bleeding during cataract surgery, one of which was combined with CyPass® Micro-Stent insertion. This resulted in complete cessation of bleeding within a minute of the injection. No further intraoperative or postoperative hemorrhage was seen. As far as we know, this is the first report of intracameral phenylephrine use intraoperatively to successfully stop anterior chamber bleeding, enabling safe completion of surgery.

Keywords: Anterior chamber bleeding; Cypass; Intracameral phenylephrine; Intraocular bleeding; Intraoperative bleeding; Intraoperative hemorrhage; Minimally invasive glaucoma surgery (MIGS).