Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery

Frank A Bucci Jr, Breanne Michalek, Angel T Fluet Bucci Laser Vision Institute, Wilkes-Barre, PA, USA Purpose: The objective of this study is to evaluate whether a phenylephrine and ketorolac injection 1%/0.3% (phenyl/keto injection) (Omidria®) prior to capsulotomy decreases the need for the...

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Autores principales:	Bucci Jr FA, Michalek B, Fluet AT
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	mydriasis cataract Malyugin Ring Omidria phenylephrine ketorolac Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/edfa5b518316413a8a146174b23502b7
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spelling	oai:doaj.org-article:edfa5b518316413a8a146174b23502b72021-12-02T08:58:25ZComparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery1177-5483https://doaj.org/article/edfa5b518316413a8a146174b23502b72017-06-01T00:00:00Zhttps://www.dovepress.com/comparison-of-the-frequency-of-use-of-a-pupil-expansion-device-with-an-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Frank A Bucci Jr, Breanne Michalek, Angel T Fluet Bucci Laser Vision Institute, Wilkes-Barre, PA, USA Purpose: The objective of this study is to evaluate whether a phenylephrine and ketorolac injection 1%/0.3% (phenyl/keto injection) (Omidria®) prior to capsulotomy decreases the need for the Malyugin Ring® to manage small pupils.Setting: Bucci Laser Vision Institute, Wilkes-Barre, PA, USA.Design: Retrospective analysis of cataract surgeries performed by a single surgeon at a single center.Methods: A historical control group of 1,004 consecutive cases (December 2013 to February 2015) did not receive a phenyl/keto intracameral injection prior to capsulotomy and were compared with 915 consecutive cases in the treatment group (June 2015 to April 2016) for the rate of use of the Malyugin Ring. Epinephrine injections were selectively used in the control group as per surgeon judgment. Use of the femtosecond laser was recorded for both groups. The incidence of alpha-1 blocker patients and the use of the femtosecond laser were recorded for both groups.Results: In the 1,004 cases performed in the historical control group without a phenyl/keto injection, the surgeon chose to use the Malyugin Ring 79 times (7.87%). In the 915 cases performed in the treatment group, the surgeon chose to use the Malyugin Ring 27 times (2.95%). The surgeon selectively used intracameral injections of epinephrine in the control group 64 times (6.47%). There was no significant difference in the use of the femtosecond laser in the control group (15.04%) versus the treatment group (16.28%); however, 4 (2.65%) femtosecond patients in the control group required a Malyugin Ring, while zero patients needed the ring in the femtosecond treatment group. The incidence of Malyugin Ring use in alpha-1 blocker patients was 12/49 (24.49%) in the control group and 6/49 (12.74%) in the treatment group (P=0.05).Conclusion: The frequency of use of the Malyugin Ring was significantly reduced (P<0.001) from 7.87% to 2.95% with this treatment. These results strongly suggest that the antimiotic/anti-inflammatory effects of this phenyl/keto injection reduced facility costs, surgical time, and other complexities related to the use of the Malyugin Ring during phacoemulsification.Keywords: mydriasis, cataract, Malyugin Ring, Omidria, phenylephrine, ketorolacBucci Jr FAMichalek BFluet ATDove Medical PressarticlemydriasiscataractMalyugin RingOmidriaphenylephrineketorolacOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 1039-1043 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	mydriasis cataract Malyugin Ring Omidria phenylephrine ketorolac Ophthalmology RE1-994
spellingShingle	mydriasis cataract Malyugin Ring Omidria phenylephrine ketorolac Ophthalmology RE1-994 Bucci Jr FA Michalek B Fluet AT Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery
description	Frank A Bucci Jr, Breanne Michalek, Angel T Fluet Bucci Laser Vision Institute, Wilkes-Barre, PA, USA Purpose: The objective of this study is to evaluate whether a phenylephrine and ketorolac injection 1%/0.3% (phenyl/keto injection) (Omidria®) prior to capsulotomy decreases the need for the Malyugin Ring® to manage small pupils.Setting: Bucci Laser Vision Institute, Wilkes-Barre, PA, USA.Design: Retrospective analysis of cataract surgeries performed by a single surgeon at a single center.Methods: A historical control group of 1,004 consecutive cases (December 2013 to February 2015) did not receive a phenyl/keto intracameral injection prior to capsulotomy and were compared with 915 consecutive cases in the treatment group (June 2015 to April 2016) for the rate of use of the Malyugin Ring. Epinephrine injections were selectively used in the control group as per surgeon judgment. Use of the femtosecond laser was recorded for both groups. The incidence of alpha-1 blocker patients and the use of the femtosecond laser were recorded for both groups.Results: In the 1,004 cases performed in the historical control group without a phenyl/keto injection, the surgeon chose to use the Malyugin Ring 79 times (7.87%). In the 915 cases performed in the treatment group, the surgeon chose to use the Malyugin Ring 27 times (2.95%). The surgeon selectively used intracameral injections of epinephrine in the control group 64 times (6.47%). There was no significant difference in the use of the femtosecond laser in the control group (15.04%) versus the treatment group (16.28%); however, 4 (2.65%) femtosecond patients in the control group required a Malyugin Ring, while zero patients needed the ring in the femtosecond treatment group. The incidence of Malyugin Ring use in alpha-1 blocker patients was 12/49 (24.49%) in the control group and 6/49 (12.74%) in the treatment group (P=0.05).Conclusion: The frequency of use of the Malyugin Ring was significantly reduced (P<0.001) from 7.87% to 2.95% with this treatment. These results strongly suggest that the antimiotic/anti-inflammatory effects of this phenyl/keto injection reduced facility costs, surgical time, and other complexities related to the use of the Malyugin Ring during phacoemulsification.Keywords: mydriasis, cataract, Malyugin Ring, Omidria, phenylephrine, ketorolac
format	article
author	Bucci Jr FA Michalek B Fluet AT
author_facet	Bucci Jr FA Michalek B Fluet AT
author_sort	Bucci Jr FA
title	Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery
title_short	Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery
title_full	Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery
title_fullStr	Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery
title_full_unstemmed	Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery
title_sort	comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/edfa5b518316413a8a146174b23502b7
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Comparison of the frequency of use of a pupil expansion device with and without an intracameral phenylephrine and ketorolac injection 1%/0.3% at the time of routine cataract surgery

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