Document Detail

Pupil size with and without adrenaline with diclofenac use before cataract surgery.
MedLine Citation:
PMID:  19631127     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To determine whether adrenaline in the irrigating solution is necessary when diclofenac eyedrops are used before cataract surgery. SETTING: Pasqua Hospital, Regina, Saskatchewan, Canada. METHODS: In this prospective randomized masked study, all patients used diclofenac eyedrops 2 days preoperatively. The pupils were dilated with a wick soaked in a dilating solution containing diclofenac. Patients were divided into 2 groups. One group had 0.5 mL of 1:1000 adrenaline in 500.0 mL of fortified balanced salt solution (BSS Plus) (adrenaline group). The other group did not (no-adrenaline group). The horizontal diameter of the pupils was measured with calipers. RESULTS: The study included 207 patients. There were no surgical complications. In the adrenaline group, the mean pupil size was 8.19 mm +/- 0.86 (SD) before the first incision, 8.14 +/- 0.87 mm after phacoemulsification, and 8.14 +/- 0.85 mm after cortical removal. In the no-adrenaline group, the means were 8.19 +/- 0.87 mm, 7.94 +/- 0.99 mm, and 7.87 +/-1.03 mm, respectively. The mean pupil constriction was 0.05 +/- 0.21 mm in the adrenaline group and 0.33 +/- 0.43 mm in the no-adrenaline group. The difference was statistically significant (Mann-Whitney test). Further analysis of preoperative pupil size showed a significant difference for smaller pupils only. CONCLUSIONS: When diclofenac eyedrops were used before cataract surgery, the smaller preoperative pupils constricted significantly less when adrenaline was added to the irrigating solution. This was not true for larger pupils. Thus, adrenaline in the irrigating solution does not appear necessary in eyes with large preoperative pupils.
Lindsay Ong-Tone; Ali Bell
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  35     ISSN:  1873-4502     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-27     Completed Date:  2009-10-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1396-400     Citation Subset:  IM    
University of Saskatchewan and Pasqua Hospital, Regina Qu'Appelle Health Region, Regina, Saskatchewan, Canada.
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MeSH Terms
Acetates / administration & dosage
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
Diclofenac / administration & dosage*
Double-Blind Method
Drug Combinations
Epinephrine / administration & dosage*
Iris / drug effects*
Lens Implantation, Intraocular
Middle Aged
Minerals / administration & dosage
Mydriatics / administration & dosage*
Ophthalmic Solutions / administration & dosage
Prospective Studies
Pupil / physiology*
Sodium Chloride / administration & dosage
Reg. No./Substance:
0/Acetates; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/BSS solution; 0/Drug Combinations; 0/Minerals; 0/Mydriatics; 0/Ophthalmic Solutions; 15307-86-5/Diclofenac; 51-43-4/Epinephrine; 7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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