Prednisolone and flurbiprofen drops to maintain mydriasis during phacoemulsification cataract surgery

Shaikh, MH; Mars, J S; Heaven, C J

doi:10.1016/s0886-3350(03)00137-8

Cited by 26 publications

(15 citation statements)

References 6 publications

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“…Shaikh and colleagues analyzed the antimiosis effect of topical prednisolone compared with flurbiprofen. There were no statistically significant differences between the two drugs; however, flurbiprofen produced greater mydriasis 20. It has been reported also that the preoperative use of ketorolac for 3 days is more effective in maintaining mydriasis than the regimen of 1 day and 1 hour preoperatively 13.…”

Section: Discussionmentioning

confidence: 79%

“…It has also demonstrated superior penetration of the intraocular tissues with adequate concentrations in the posterior segment to inhibit the synthesis of PGs 27,28,30,31. Multiple studies have demonstrated that NSAIDs are effective drugs for maintaining trans-operative mydriasis13,16–20 and in preventing and treating pseudophakic CME 21–26…”

Section: Discussionmentioning

confidence: 99%

“…When PG release is inhibited with topical NSAIDs, adequate mydriasis is maintained during surgery, thereby decreasing trans-operative complications such as posterior capsule rupture 15. Currently, different non-invasive methods exist that prevent miosis during surgery; however, the use of preoperative topical NSAIDs, in combination with conventional topical mydriatics (anticholinergic and sympathomimetic), is widely practiced 13,16–20…”

Section: Introductionmentioning

confidence: 99%

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Inhibition of surgically induced miosis and prevention of postoperative macular edema with nepafenac

Cervantes-Coste

Sánchez-Castro²,

Orozco-Carroll³

et al. 2009

OPTH

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Objective:To evaluate the effectiveness of prophylactic administration of nepafenac 0.1% in maintaining mydriasis and in preventing postoperative macular edema following cataract surgery.Methods:This was a prospective, randomized, single-masked comparative study in 60 patients undergoing phacoemulsification cataract surgery. Patients were randomized to either the nepafenac or the control group. Nepafenac was administered 3 times daily 1 day before surgery and continued for 6 weeks. The control group received tobramycin-dexamethasone treatment only. Trans-operative mydriasis was measured before surgery, after nuclear emulsification, following cortex aspiration, and at the conclusion of surgery. Macular optical coherence tomography determined central foveal thickness (FT) and total macular volume (TMV) before surgery and at 2 and 6 weeks after surgery. All patients received tobramycin-dexamethasone for 2 weeks after surgery.Results:The difference in mean pupil size, at the end of surgery, between the control group (6.84 ± 0.93 mm) and the nepafenac group (7.91 ± 0.74 mm) was statistically significant (p < 0.001). There were no significant differences in FT values between the two groups at any time point; however, TMV at 2 and at 6 weeks was statistically significantly different (p < 0.001), with higher TMV in the control group.Conclusion:Prophylactic use of nepafenac was effective in reducing macular edema after cataract surgery and in maintaining trans-operative mydriasis.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inhibition of surgically induced miosis and prevention of postoperative macular edema with nepafenac

Cervantes-Coste

Sánchez-Castro²,

Orozco-Carroll³

et al. 2009

OPTH

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“…Topical NSAIDs (Non- Steroidal Anti-inflammatory Drugs) are used as preoperative medication routinely to prevent this pupillary constriction. [3233343536] In this study we have not used any preoperative NSAID, and yet the pupillary dilatation was maintained. This is an important requirement for safe removal of lens matter and is well catered by our technique of mydriasis.…”

Section: Discussionmentioning

confidence: 99%

Phacoemulsification without preoperative topical mydriatics: Induction and sustainability of mydriasis with intracameral mydriatic solution

Gupta¹,

Kumar²,

Agarwal³

et al. 2014

Indian J Ophthalmol

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Context:Intracameral mydriatic solution can eliminate the disadvantages of repeated eye drop instillation regimen and provide adequate mydriasis for phacoemulsification with added advantages.Aims:Evaluating the role of intracameral irrigating solution (0.5% lignocaine + 0.001% epinephrine) in initiating and maintaining the pupillary mydriasis during phacoemulsification. Secondary aims were to observe the effect of surgical time, nucleus density and ultrasound time on mydriasis during the procedure.Settings and Design:The study is a prospective interventional case series, conducted at tertiary care institution.Materials and Methods:Thirty patients underwent phacoemulsification under topical anesthesia for visually significant cataract. Pupillary dilatation was achieved by intracameral irrigation of mydriatic solution alone. Pupillary diameter was measured serially during surgery and ultrasound time and total surgical time were noted.Statistical Analysis Used:Paired samples student–t test was done to compare means. Spearman correlation coefficient was used to study the effect of various parameters on mydriasis.Results:Thirty eyes completed the study. The pupil size increased from 2.1 mm (Range 2-3.5 mm SD ± 0.32) to 6.9 mm (Range 5-9 mm SD ± 1.02) in 30 seconds time after intracameral mydriatic solution delivery, and was 7.0 mm (Range 3.5 - 9 mm SD ± 0.20) at the end of surgery. Duration of surgery, grade of nucleus and ultrasound time had statistically insignificant effect on mydriasis.Conclusions:Intracameral solution containing 0.5% lignocaine and 0.001% epinephrine provides rapid mydriasis which is adequate for safe phacoemulsification and is unaffected by other parameters.

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“…Unlike nonsteroidal agents, steroid eye drops have not been extensively studied for their antimiotic effect. [7][8][9] Cataract surgery complications increase when miosis occurs. It was reported that, when mydriasis is greater than 6 mm, the incidence of posterior capsule rupture is reduced by half.…”

Section: Introductionmentioning

confidence: 99%

A study on effect of pre-operative topical prednisolone acetate, nepafenac and placebo, on intraoperative mydriasis and its sustenance during cataract surgery: a randomized trial

Sethi

Chalia

et al. 2015

Int J Basic Clin Pharmacol

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Prednisolone and flurbiprofen drops to maintain mydriasis during phacoemulsification cataract surgery

Abstract: In the presence of epinephrine in the intraocular irrigating solution, both prednisolone 1% and flurbiprofen 0.03% failed to maintain mydriasis at the crucial steps of nuclear emulsification and cortical I/A.

Cited by 26 publications

References 6 publications

Inhibition of surgically induced miosis and prevention of postoperative macular edema with nepafenac

Inhibition of surgically induced miosis and prevention of postoperative macular edema with nepafenac

Phacoemulsification without preoperative topical mydriatics: Induction and sustainability of mydriasis with intracameral mydriatic solution

A study on effect of pre-operative topical prednisolone acetate, nepafenac and placebo, on intraoperative mydriasis and its sustenance during cataract surgery: a randomized trial

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