Monday, September 20, 2010
Don’t be afraid to use a little “Shugar”. The late Dr. Joel Shugar will be remembered for many things, among which is his intracameral cocktail to maintain pupil dilation and decrease iris tone. To create epi-shugarcaine, 9 mL of BSS Plus are mixed with 4 mL of 1:1,000 bisulfite-free epinephrine and 3 mL of 4% preservative-free lidocaine. A small aliquot is injected into the anterior chamber at the beginning of the case and allowed to “marinate” with the iris for at least 15 seconds before proceeding. In my experience I have found this regimen to be 100% successful in patients with a history of flomax use whose pupils dilate sufficiently at the time of surgery. A great demonstration of the effect of shugarcaine is demonstrated in this video. In the previous video (Intracameral Lidocaine in Cataract Surgery) only intracameral lidocaine was given. In this video, intracameral shugarcaine was given. The difference is dramatic, and is now the reason I use shugarcaine as my intracameral injection on all cataract patients.