A Comparison of Topical Nepafenac with Ketorolac Tromethamine in Maintaining Pupilary Dilatation during Phacoemulsification

Abstract

Background: The standard surgical procedure for cataract surgery now a days is phacoemulsification with  intraocular lens (IOL) implantation, that gives excellent visual results. Stable and adequate mydriasis is  equired throughout phacoemulsification surgery. Intraoperative pupil Constriction  (miosis) is associated with an increased risk of intraoperative complications especially in  difficult cases and it can result in prolonged surgical time. Objective:  To compare the effectiveness of prophylactic administration of topical ketorolac  tromethamine 0.5% and nepafenac 0.1% on maintaining mydriasis during phacomulsification when instilled for 1 hour (I drop every 15 minutes) before surgery.  Material and Methods: In this study a total of 490 eyes were included (that is 245 eyes in each group), using efficacy of Nepafenac equal to 17.32% and that of ketorolac tromethamine equal to 27.89%,  in terms of loss of pupil  mydriasis from baseline till end of phacoemulsification. Power of test is equal to 80% and level of significance is equal to 5%.   Results: In this study mean age in Group A (nepafenac 0.1%) was 62 year.  while mean age in Group B (ketorolac tromethamine 0.5%) was 64 year with standard deviation  ± 2.87. In Group A (nepafenac 0.1%),(55%) patients were male and (45%) patients were female.  Where as in Group B (ketorolac tromethamine 0.5%), (57%) patients were male and (43%)  patients were female. Conclusion: Our study concludes that Nepafenac 0.1% is more effective than ketorolac tromethamine 0.5% in  maintenance of dilated pupil during phacoemulsification surgery.  KEY WORDS: Nepafenac 0.1%, ketorolac tromethamine 0.5%, dilated pupil,  phacoemulsification surgery