The Effect of Prophylactic Administration of Ketorolac Ophthalmic Suspension on Prevention of Surgically Induced Miosis in Patients Undergoing Cataract Surgery
Background: Cataract extraction surgery remains the most commonly performed eye surgery by ophthalmologists. The maintenance of mydriasis is required throughout surgery to allow better visualization of the surgical field and a greater working space within the center of the eye. Non-steroidal anti-in...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2016-06-01
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| Series: | Archives of Anesthesia and Critical Care |
| Subjects: | |
| Online Access: | https://aacc.tums.ac.ir/index.php/aacc/article/view/76 |
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| author | Mehdi Sanatkar Mehrdad Goudarzi Hamed Ghassemi Mahsa Keyhanian Amir Abbas Yaghooti Hossein Sadrossadat Reza Ghafari Shahrokh Ghazizadeh Hassan Mohammadi Poor Anvari Somaye Asadi |
| author_facet | Mehdi Sanatkar Mehrdad Goudarzi Hamed Ghassemi Mahsa Keyhanian Amir Abbas Yaghooti Hossein Sadrossadat Reza Ghafari Shahrokh Ghazizadeh Hassan Mohammadi Poor Anvari Somaye Asadi |
| author_sort | Mehdi Sanatkar |
| collection | DOAJ |
| description | Background: Cataract extraction surgery remains the most commonly performed eye surgery by ophthalmologists. The maintenance of mydriasis is required throughout surgery to allow better visualization of the surgical field and a greater working space within the center of the eye. Non-steroidal anti-inflammatory agents (NSAIDs) have their effect in maintaining mydriasis by their ability to inhibit prostaglandin synthesis.
Methods: This was a prospective, randomized clinical trial study in 84 patients undergoing phacoemulsification cataract surgery. Patients were randomized to ketorolac tromethamine 0.5% (n=42) or the control group (n=42). Patients in the ketorolac group received one drop of ketorolac every 15 min for a total of 4 drops from one hour before surgery. The horizontal diameters of the pupil were measured in millimeters with a caliper under the microscope at the following stages: before surgery, after intracameral epinephrine injection, after nuclear emulsification and at the end of surgery.
Results: The difference in pupillary diameter at the end of surgery was statistically significant between two groups (7.34 ± 1.0 mm and 8.01 ±0.67 mm in the control and the ketorolac groups, respectively; p=0.018). The difference in mean pupil size after intracameral epinephrine injection and after nuclear emulsification between the control group (0.51 ± 0.25 mm) and the ketorolac group (0.01 ± 0.20 mm) was statistically significant (p <0.001). Moreover, the difference in mean pupil size after intracameral epinephrine injection and at the end of surgery between the control group (0.79 ± 0.44 mm) and the ketorolac group (0.19 ± 0.23 mm) was statistically significant (p <0.001). There was no difference in maintaining mydriasis between diabetic patients and non-diabetic patients.
Conclusion: Topical ketorolac is an effective inhibitor of miosis during phacoemulsification cataract surgery, and provides a more stable mydriatic effect throughout the surgical procedure. |
| first_indexed | 2024-04-13T01:08:35Z |
| format | Article |
| id | doaj.art-203b9250e6b842c0975f299b132f7744 |
| institution | Directory Open Access Journal |
| issn | 2423-5849 |
| language | English |
| last_indexed | 2024-04-13T01:08:35Z |
| publishDate | 2016-06-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Archives of Anesthesia and Critical Care |
| spelling | doaj.art-203b9250e6b842c0975f299b132f77442022-12-22T03:09:14ZengTehran University of Medical SciencesArchives of Anesthesia and Critical Care2423-58492016-06-0122The Effect of Prophylactic Administration of Ketorolac Ophthalmic Suspension on Prevention of Surgically Induced Miosis in Patients Undergoing Cataract SurgeryMehdi Sanatkar0Mehrdad Goudarzi1Hamed Ghassemi2Mahsa Keyhanian3Amir Abbas Yaghooti4Hossein Sadrossadat5Reza Ghafari6Shahrokh Ghazizadeh7Hassan Mohammadi Poor Anvari8Somaye Asadi9Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran.Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran.Department of Ophthalmology, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, IranGeneral Physician of Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IranDepartment of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran.Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, IranDepartment of Ophthalmology, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran.Department of Surgery, Tehran University of Medical Sciences, Razi Hospital, Tehran, IranDepartment of Anesthesiology and Critical Care, Tabriz University of Medical Sciences, Imam Reza Hospital, Tabriz, IranBS Student of Nutrition/Ms Student in Health Management, Tehran University of Medical Sciences, Farabi Eye Hospital,Tehran, IranBackground: Cataract extraction surgery remains the most commonly performed eye surgery by ophthalmologists. The maintenance of mydriasis is required throughout surgery to allow better visualization of the surgical field and a greater working space within the center of the eye. Non-steroidal anti-inflammatory agents (NSAIDs) have their effect in maintaining mydriasis by their ability to inhibit prostaglandin synthesis. Methods: This was a prospective, randomized clinical trial study in 84 patients undergoing phacoemulsification cataract surgery. Patients were randomized to ketorolac tromethamine 0.5% (n=42) or the control group (n=42). Patients in the ketorolac group received one drop of ketorolac every 15 min for a total of 4 drops from one hour before surgery. The horizontal diameters of the pupil were measured in millimeters with a caliper under the microscope at the following stages: before surgery, after intracameral epinephrine injection, after nuclear emulsification and at the end of surgery. Results: The difference in pupillary diameter at the end of surgery was statistically significant between two groups (7.34 ± 1.0 mm and 8.01 ±0.67 mm in the control and the ketorolac groups, respectively; p=0.018). The difference in mean pupil size after intracameral epinephrine injection and after nuclear emulsification between the control group (0.51 ± 0.25 mm) and the ketorolac group (0.01 ± 0.20 mm) was statistically significant (p <0.001). Moreover, the difference in mean pupil size after intracameral epinephrine injection and at the end of surgery between the control group (0.79 ± 0.44 mm) and the ketorolac group (0.19 ± 0.23 mm) was statistically significant (p <0.001). There was no difference in maintaining mydriasis between diabetic patients and non-diabetic patients. Conclusion: Topical ketorolac is an effective inhibitor of miosis during phacoemulsification cataract surgery, and provides a more stable mydriatic effect throughout the surgical procedure.https://aacc.tums.ac.ir/index.php/aacc/article/view/76cataract surgeryketorolac tromethaminemydriasismiosispupil diameter |
| spellingShingle | Mehdi Sanatkar Mehrdad Goudarzi Hamed Ghassemi Mahsa Keyhanian Amir Abbas Yaghooti Hossein Sadrossadat Reza Ghafari Shahrokh Ghazizadeh Hassan Mohammadi Poor Anvari Somaye Asadi The Effect of Prophylactic Administration of Ketorolac Ophthalmic Suspension on Prevention of Surgically Induced Miosis in Patients Undergoing Cataract Surgery Archives of Anesthesia and Critical Care cataract surgery ketorolac tromethamine mydriasis miosis pupil diameter |
| title | The Effect of Prophylactic Administration of Ketorolac Ophthalmic Suspension on Prevention of Surgically Induced Miosis in Patients Undergoing Cataract Surgery |
| title_full | The Effect of Prophylactic Administration of Ketorolac Ophthalmic Suspension on Prevention of Surgically Induced Miosis in Patients Undergoing Cataract Surgery |
| title_fullStr | The Effect of Prophylactic Administration of Ketorolac Ophthalmic Suspension on Prevention of Surgically Induced Miosis in Patients Undergoing Cataract Surgery |
| title_full_unstemmed | The Effect of Prophylactic Administration of Ketorolac Ophthalmic Suspension on Prevention of Surgically Induced Miosis in Patients Undergoing Cataract Surgery |
| title_short | The Effect of Prophylactic Administration of Ketorolac Ophthalmic Suspension on Prevention of Surgically Induced Miosis in Patients Undergoing Cataract Surgery |
| title_sort | effect of prophylactic administration of ketorolac ophthalmic suspension on prevention of surgically induced miosis in patients undergoing cataract surgery |
| topic | cataract surgery ketorolac tromethamine mydriasis miosis pupil diameter |
| url | https://aacc.tums.ac.ir/index.php/aacc/article/view/76 |
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