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Randomized Controlled Trial
. 2012 Jul;60(4):277-81.
doi: 10.4103/0301-4738.98705.

Effect of preoperative use of topical prednisolone acetate, ketorolac tromethamine, nepafenac and placebo, on the maintenance of intraoperative mydriasis during cataract surgery: a randomized trial

Fernando Roberte Zanetti  1 , Enzo Augusto Medeiros Fulco, Fernando Rodrigo Pedreira Chaves, Alexandre Paashaus da Costa Pinto, Carlos Eduardo Leite Arieta, Rodrigo Pessoa Cavalcanti Lira
Affiliations
Randomized Controlled Trial

Effect of preoperative use of topical prednisolone acetate, ketorolac tromethamine, nepafenac and placebo, on the maintenance of intraoperative mydriasis during cataract surgery: a randomized trial

Fernando Roberte Zanetti et al. Indian J Ophthalmol. 2012 Jul.

Abstract

Purpose: To compare the effects of preoperative use of topical anti-inflammatory prednisolone acetate, ketorolac tromethamine, nepafenac and placebo, on the maintenance of intraoperative mydriasis during cataract surgery.

Design: Randomized clinical trial.

Materials and methods: This single-center, masked, randomized clinical study comprised 140 patients scheduled for cataract surgery. Patients (35 in each group) were randomized to receive placebo, prednisolone acetate, ketorolac tromethamine 0.4% or nepafenac. These eye drops were administered three times daily for the two days prior to surgery. The pupillary diameters were measured by the surgeon using a compass prior to the corneal section and at the end of surgery. The primary outcome was the number of patients with pupil ≥ 6mm at the end of the surgery; the secondary outcome was the number of patients with pupil ≥ 6mm at the beginning of the surgery.

Results: All the patients achieved pupil ≥ 6mm at the beginning of the surgery. The number of patients in the prednisolone (29/35), nepafenac (31/35) and ketorolac (30/35) groups with pupil ≥ 6mm was greater than in the placebo group in the maintenance of intraoperative mydriasis (19/35 - P =0.003). There was no statistical difference among the prednisolone, nepafenac and ketorolac groups in the maintenance of intraoperative mydriasis (P =.791). There were no complications during surgery or related to the preoperative use of the eye drops.

Conclusion: Preoperative use of ketorolac, prednisolone and nepafenac was effective in maintaining intraoperative mydriasis when compared with placebo.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
CONSORT flow diagram: Effect of preoperative use of topical prednisolone acetate, ketorolac tromethamine, nepafenac and placebo, in the maintenance of intraoperative mydriasis during cataract surgery
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Comment in

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