Optimizing Mydriasis in Cataract Surgery: Efficacy and Safety of Intracameral Regimen versus Topical Cyclopentolate in RayOne EMV Implantation

Background: This retrospective study compared the safety and efficacy of phacoemulsification performed with topical Cyclopentolate (Cykloftyal) versus a standard intracameral mydriatic and anesthetic combination (Mydrane) in patients undergoing RayOne EMV intraocular lens implantation. Materials and Methods: Medical records of 60 eyes (30 patients per group) were analyzed. Group A received topical Cyclopentolate and intracameral lidocaine, whereas Group B received intracameral Mydrane alone for mydriasis and anesthesia. Data on pupil diameter (at the start and end of surgery), procedure duration, and postoperative visual acuity at various distances were extracted and compared. Results: There was no statistically significant difference in surgical duration between Group A (7.05 min) and Group B (6.70 min; p=0.35), nor in postoperative visual acuity at any distance. However, the initial pupil diameter was significantly larger in the topical group (7.31±1.12 mm) than in the intracameral group (6.19±0.92 mm; p=0.04). Two months postoperatively, approximately 67% of patients in both groups reported spectacle independence for daily activities. Conclusions: Topical Cyclopentolate is a safe and effective alternative to intracameral mydriasis, providing significantly wider initial pupil dilation while maintaining comparable surgical efficiency. Additionally, the RayOne EMV lens demonstrated favorable outcomes in functional spectacle independence.