Rosenberg ED, et al. - Researchers undertook a comparative scrutiny of the visual outcomes, surgical time, and perioperative surgical complications after intracameral use of either phenylephrine/ketorolac (P/K) or epinephrine (Epi) during cataract surgery. During cataract surgery, intracameral use of phenylephrine 1.0%/ketorolac 0.3% could be effective in maintaining mydriasis. It was possibly found to be superior to intracameral Epi at reducing intraoperative and postoperative complications. Additionally, it appeared to reduce the need for pupillary dilating devices and surgical time.

Methods

• The scheme of this study was a single-center, retrospective case review.
• The eligible candidates included patients undergoing cataract surgery from August to November 2015.
• Among 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.
• A topical nonsteroidal anti-inflammatory drug regimen (bromfenac 0.07%, nepafenac 0.3%, or ketorolac 0.5%) was recieved by all patients for 3 days before surgery and topical tropicamide 1.0%, cyclopentolate 1.0%, and phenylephrine 2.5% on the day of surgery.

Results

• Findings revealed that the mean length of surgery (LOS) was 15.4&plysmn;0.6 minutes.
• A positive link was determined between patient age and LOS (p < 0.001).
• Nonetheless, P/K correlated with a decrease in the LOS, when controlled for age quartiles.
• Data illustrated a statistically prominent, lower incidence of complications (1.1%) with P/K use than Epi (4.5%; p=0.018).
• A connection was brought to the limelight between P/K use with a reduction in the use of these devices (p < 0.001) among surgeons who used mydriatic-assist devices more frequently.
• A prominently better uncorrected visual acuity was displayed in patients of age groups 69-76 and 76-92 years who received P/K at postoperative day 1 when compared to those receiving Epi (p=0.003), when controlling for age quartile.