Prednisolone and flurbiprofen drops to maintain mydriasis during phacoemulsification cataract surgery.

PURPOSE

To compare the effects on the pupil of pretreatment with prednisolone 1% eyedrops, flurbiprofen 0.03% eyedrops, and sodium chloride 0.9% eyedrops in patients having phacoemulsification cataract surgery.

SETTING

Christopher Home Eye Unit, Royal Albert Edward Infirmary, Wigan, United Kingdom.

METHODS

One hundred thirty-six white patients having phacoemulsification with no history of eye disease, antiinflammatory medication, or diabetes were enrolled in this prospective randomized double-blind study. Patients were allocated to receive flurbiprofen 0.03%, prednisolone 1%, or sodium chloride 0.9% (placebo) eyedrops at 30-minute intervals beginning 2 hours before surgery. All patients received cyclopentolate 1% and phenylephrine 2.5% drops preoperatively and epinephrine 1:10(6) intraoperatively in the intraocular irrigating solution. The pupil diameter was measured from a television screen at the preset magnification of the operating microscope immediately before the incision, at the end of nucleus emulsification, at the end of irrigation/aspiration (I/A), and at the end of surgery. One hundred twelve patients with a baseline pupil diameter of at least 6.0 mm who had uneventful phacoemulsification were analyzed.

RESULTS

The baseline pupil diameters were statistically similar. An analysis of variance did not reveal an overall significant mydriasis-maintaining effect of prednisolone or flurbiprofen compared to the placebo at any stage of surgery (P =.16 to.37). The 95% confidence interval showed flurbiprofen to be superior to prednisolone at the end of surgery. According to the paired t test, the reduction from the baseline at the end of I/A in the prednisolone group (P =.051) and at the end of surgery in the flurbiprofen group (P =.22) was not significant.

CONCLUSION

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.