Effects on Intraocular Pressure during Cataract Surgery with Intravenous Remifentanyl and Dexmedetomidine - A Comparative Study

Aims and objectives: To compare the effects of intravenous infusion of remifentanil and dexmedetomidine on the intraocular pressure (IOP) of patients who underwent cataract surgery. Methods: Ninety consecutive patients aged between 20 and 65 who had been scheduled for elective cataract surgery were included in the study. Patients were divided into 3 groups as control (Group C), remifentanil infusion (Group R) and dexmedetomidine infusion (Group D). Preoperative intraocular pressures and hemodynamics were evaluated. Results: According to intraocular pressure levels, although the IOP decreased at the drug loading dose, induction, it was statistically significantly higher in Group C than in Group R and Group D (p< 0.001). However, in these periods there was no statistically significant difference between Group R and Group D. In the postoperative period, the IOP measurements of Group D were significantly lower than those of Group C and Group R, 16.81±1.65 mm Hg, 18.21±1.98 mm Hg, 18.17±1.29 mm Hg, respectively (p< 0.002). Blood pressure and heart rate values decreased more in Group R and Group D compared to Group C during the operation (p < 0.001). Conclusions: Remifentanil and dexmedetomidine are agents that can be used in intravenous infusions for controlled hypo tension in eye surgeries where low IOP is desired. Intraoperative hemodynamic effects are similar. However, considering that it decreases IOP values more in the intraoperative period and lowers IOP values in the postoperative period compared to remifentanil, we believe that dexmedetomidine can be preferred primarily. J.Natl.Inst.Ophthalmol.2025;8(1): 36-41