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

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...

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Autores principales:	Rosenberg ED, Nattis AS, Alevi D, Chu RL, Bacotti J, LoPinto RJ, D'Aversa G, Donnenfeld ED
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	cataract surgery complications pupillary miosis phenylephrine ketorolac Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c8750b99763c4ab3a47fb75c84b188d8
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spelling	oai:doaj.org-article:c8750b99763c4ab3a47fb75c84b188d82021-12-02T09:01:34ZVisual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery1177-5483https://doaj.org/article/c8750b99763c4ab3a47fb75c84b188d82017-12-01T00:00:00Zhttps://www.dovepress.com/visual-outcomes-efficacy-and-surgical-complications-associated-with-in-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Eric 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, ketorolacRosenberg EDNattis ASAlevi DChu RLBacotti JLoPinto RJD'Aversa GDonnenfeld EDDove Medical Pressarticlecataract surgerycomplicationspupillary miosisphenylephrineketorolacOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 21-28 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	cataract surgery complications pupillary miosis phenylephrine ketorolac Ophthalmology RE1-994
spellingShingle	cataract surgery complications pupillary miosis phenylephrine ketorolac Ophthalmology RE1-994 Rosenberg ED Nattis AS Alevi D Chu RL Bacotti J LoPinto RJ D'Aversa G Donnenfeld ED Visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery
description	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
format	article
author	Rosenberg ED Nattis AS Alevi D Chu RL Bacotti J LoPinto RJ D'Aversa G Donnenfeld ED
author_facet	Rosenberg ED Nattis AS Alevi D Chu RL Bacotti J LoPinto RJ D'Aversa G Donnenfeld ED
author_sort	Rosenberg ED
title	Visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery
title_short	Visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery
title_full	Visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery
title_fullStr	Visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery
title_full_unstemmed	Visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery
title_sort	visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/c8750b99763c4ab3a47fb75c84b188d8
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Visual outcomes, efficacy, and surgical complications associated with intracameral phenylephrine 1.0%/ketorolac 0.3% administered during cataract surgery

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