Abstract | PURPOSE: To compare the effects of topical nonsteroidal anti-inflammatory drugs on pupil dilation maintenance during phacoemulsification cataract surgery and quantify the relationships between pupil size change and nuclear hardness. METHODS: This prospective randomized clinical observation study was single centered and double-masked. We studied 239 cases undergoing uneventful phacoemulsification cataract surgery in the absence of significant ocular comorbidity. Cases were randomly assigned to 1 of 6 groups receiving the following treatments: (1) diclofenac (0.1%); (2) pranoprofen (0.1%); (3) control, physiological normal saline solution; (4) diclofenac (0.1%) and epinephrine; (5) pranoprofen (0.1%) and epinephrine; (6) control, physiological normal saline and epinephrine solutions. Pupil diameter was measured at 3 intervals of cataract surgery: before the first incision, at the end of nucleus fragmentation, and at the end of cortex irrigation/aspiration. RESULTS: Compared with patients who were not treated, there was a significant difference in maintaining pupil dilation throughout the operation when the patients were treated with either diclofenac or pranoprofen, P<0.001 and P<0.03, respectively. From the first incision to postnucleus fragmentation, the change in pupil size in both diclofenac and control groups was significantly associated with the hardness of the crystalline lens, P=0.001 and P=0.012, respectively. At the end of irrigation/aspiration, the change in pupil size in only the control groups was significantly associated with the hardness of the crystalline lens, P=0.022. Diclofenac treatment was most effective at inhibiting pupil miosis when the hardness of the nucleus was grade 3, P=0.009. Pupil miosis was not related to the hardness of the nucleus when the patients were treated with epinephrine. CONCLUSIONS:
|
Authors | Chang Liu, Yuhua Liu, Shaobi Ye, Liangping Liu, Wanjun Zhang, Mingxing Wu |
Journal | Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics
(J Ocul Pharmacol Ther)
Vol. 30
Issue 10
Pg. 831-6
(Dec 2014)
ISSN: 1557-7732 [Electronic] United States |
PMID | 25230350
(Publication Type: Journal Article, Observational Study, Randomized Controlled Trial)
|
Chemical References |
- Anti-Inflammatory Agents, Non-Steroidal
- Benzopyrans
- Mydriatics
- Ophthalmic Solutions
- Propionates
- Diclofenac
- pyranoprofen
- Epinephrine
|
Topics |
- Administration, Ophthalmic
- Aged
- Anti-Inflammatory Agents, Non-Steroidal
(administration & dosage)
- Benzopyrans
(administration & dosage)
- Cataract
(pathology)
- Diclofenac
(administration & dosage)
- Double-Blind Method
- Epinephrine
(administration & dosage)
- Female
- Humans
- Lens Nucleus, Crystalline
(pathology)
- Male
- Middle Aged
- Miosis
(prevention & control)
- Mydriatics
(administration & dosage)
- Ophthalmic Solutions
(administration & dosage)
- Phacoemulsification
(methods)
- Propionates
(administration & dosage)
- Prospective Studies
- Pupil
(drug effects)
|