Intracameral phenylephrine and ketorolac during cataract surgery to maintain intraoperative mydriasis and reduce postoperative ocular pain: Integrated results from 2 pivotal phase 3 studies

Abstract

Dr. Schaaf is an employee and holds an equity interest in Omeros Corporation. Drs. Hovanesian, Sheppard, Trattler, Gayton, and Ng are consultants to Omeros Corporation. No other author has a financial or proprietary interest in any material or method mentioned.

Assessing the accuracy of intracameral phenylephrine preparation in cataract surgery

“…The intracameral route is increasingly being utilised for drug delivery during cataract surgery [1][2][3][4]. Such medical adjuncts to surgery have been shown to reduce surgical complications and improve patient comfort [5][6][7]. Intracameral phenylephrine has been shown in numerous studies to be safe and effective with respect to intra-operative pupil dilatation and also in the management of floppy iris syndrome [1][2][3][4][5][6][7][8][9][10].…”

“…Such medical adjuncts to surgery have been shown to reduce surgical complications and improve patient comfort [5][6][7]. Intracameral phenylephrine has been shown in numerous studies to be safe and effective with respect to intra-operative pupil dilatation and also in the management of floppy iris syndrome [1][2][3][4][5][6][7][8][9][10]. Some studies even suggest that intracameral phenylephrine is preferable to mechanical dilation devices during phacoemulsification, in terms of ease of use, reduced surgical time and lower financial costs [11].…”

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

“…The initial effect achieved by topical mydriatics, however, may not be sustained throughout the procedure 2. Even with the use of topical mydriatic drops, intraoperative miosis due to the release of prostaglandins in response to surgical trauma may still occur 6. The preoperative use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) can improve maintenance of the intraoperative pupil diameter and reduce postoperative discomfort 6.…”

“…Even with the use of topical mydriatic drops, intraoperative miosis due to the release of prostaglandins in response to surgical trauma may still occur 6. The preoperative use of topical nonsteroidal anti-inflammatory drugs (NSAIDs) can improve maintenance of the intraoperative pupil diameter and reduce postoperative discomfort 6. Topical and intracameral NSAIDs can contribute to the maintenance of dilation by blocking the miotic effects of prostaglandins released during cataract surgery.…”

Prevention and treatment of cystoid macular edema after cataract surgery

“…83 Omidria is known to prevent perioperative miosis and to reduce pain after cataract surgery. 67,[82][83][84][85] Its efficacy with respect to the prevention of postoperative inflammation and CME remains to be investigated.…”