visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery

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ID: 233976
2017
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Abstract
Eric D Rosenberg,1 Alanna S Nattis,2 David Alevi,3 Rachel L Chu,4 Joseph Bacotti,3 Ronald J LoPinto,3 Gerald D’Aversa,3 Eric D Donnenfeld51New York Medical College, Valhalla, NY, 2Lindenhurst Eye Physicians and Surgeons, Babylon, NY, 3Ophthalmic Consultants of Long Island, Rockville Centre, NY, 4Cornell University, Ithaca, NY, 5New York University Medical Center, New York, NY, USA Aim: The purpose of this study was to compare visual outcomes, surgical time, and perioperative surgical complications after intracameral use of either phenylephrine/ketorolac (P/K) or epinephrine (Epi) during cataract surgery.Methods: This was a single-center, retrospective case review of patients undergoing cataract surgery from August to November 2015. Of the 641 eyes of 389 patients who underwent cataract surgery, 260 eyes were administered phenylephrine 1.0%/ketorolac 0.3% and 381 eyes received Epi in the irrigation solution intraoperatively. All patients received a topical nonsteroidal anti-inflammatory drug regimen (bromfenac 0.07%, nepafenac 0.3%, or ketorolac 0.5%) for 3 days before surgery and topical tropicamide 1.0%, cyclopentolate 1.0%, and phenylephrine 2.5% on the day of surgery.Results: Mean length of surgery (LOS) was 15.4±0.6 minutes. Although a positive correlation was noted between patient age and LOS (p<0.001), P/K was associated with a decrease in the LOS, when controlled for age quartiles. A statistically significant lower incidence of complications (1.1%) was observed with P/K use than Epi (4.5%; p=0.018). Among surgeons who used mydriatic-assist devices more frequently, P/K use was associated with a reduction in the use of these devices (p<0.001). When controlling for age quartile, patients of age groups 69–76 and 76–92 years who received P/K had significantly better uncorrected visual acuity at postoperative day 1 than those receiving Epi (p=0.003).Conclusion: Intracameral use of phenylephrine 1.0%/ketorolac 0.3% during cataract surgery may be effective in maintaining mydriasis. It appears to be superior to intracameral Epi at reducing intraoperative and postoperative complications, need for pupillary dilating devices, and surgical time. Keywords: cataract surgery, complications, pupillary miosis, phenylephrine, ketorolac
Reference Key
ed2017clinicalvisual Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Rosenberg ED;Nattis AS;Alevi D;Chu RL;Bacotti J;LoPinto RJ;D'Aversa G;Donnenfeld ED
Journal e3s web of conferences
Year 2017
DOI
DOI not found
URL
https://www.dovepress.com/visual-outcomes-efficacy-and-surgical-complications-associated-with-in-peer-reviewed-article-OPTH
Keywords
complications phenylephrine

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