Comparison of the effects of 1/10,000 and 1/100,000 concentrations of intracameral epinephrine on corneal endothelium and macular thickness after uncomplicated phacoemulsification

To evaluate the changes in the corneal endothelial cell parameters and macular thickness after intraocular application of epinephrine $$\frac{1}{{10,000}}$$ and epinephrine$$\frac{1}{{100,000}}$$. In this study, 210 eyes from 210 patients with age-related cataracts who underwent uncomplicated surgery were included. For all patients, specular microscopy of the corneal endothelium and macular OCT were performed before surgery and 3 months after the surgery. Patients were divided randomly into three groups: without drug (control group), epinephrine $$\frac{1}{{10,000}}$$, and epinephrine$$\frac{1}{{100,000}}$$. Three months after the surgery, specular microscopy of the cornea and macular OCT measurements were performed. Measurements were compared between the three groups. Postoperative measurements were also compared with those measurements obtained before surgery. All the three groups showed a statistically significant decrease in the endothelial cell density after surgery; the reduction in endothelial cell density in the epinephrine $$\frac{1}{{10,000}}$$ group was significantly more than those of the other two groups (P value < 0.001). Hexagonality of endothelial cells was significantly reduced in the three groups after the surgery, the epinephrine $$\frac{1}{{10,000}}$$ group had more reduction compared with both other groups (P values < 0.001). All the three groups showed a statistically significant increase in the macular thickness after the surgery (P values < 0.001). The mean increase in the macular thickness in the epinephrine $$\frac{1}{{10,000}}$$ group was significantly more than those of the other two groups (P values < 0.05). Toxicity of the drug to many endothelial cell parameters and macula was reduced with decreasing concentration of epinephrine to $$\frac{1}{{100,000}}$$.