The maintenance of per-operative mydriasis in phacoemulsification with topical diclofenac sodium.
OBJECTIVE
To determine whether the use of topical diclofenac sodium (diclofenac) pre-operatively improves the maintenance of per-operative mydriasis, in conjunction with irrigating solutions containing adrenaline.


METHODS
Sixty-four consecutive patients undergoing phacoemulsification were randomised to receive either diclofenac or no diclofenac in conjunction with cyclopentolate 1% and phenylephrine 10% pre-operatively. They subsequently underwent routine phacoemulsification by one consultant surgeon. Irrigating solutions of balanced salt solution contained adrenaline 1:10(6). Pupil diameters were measured pre-sclerostomy, post-phacoemulsification, post-irrigation/aspiration and on day 1 post-operatively. These were then compared by Student's t-test.


RESULTS
The two groups were statistically similar in age and sex. The mean pre-sclerostomy pupillary diameters were 8.1 mm in both groups. The mean post-phacoemulsification diameters were 7.6 mm in those receiving diclofenac and 7.2 mm in those not (p = 0.03). The mean diameters after infusion/aspiration were 7.7 mm in those receiving diclofenac and 7.1 mm in those not (p = 0.008). The mean pupillary diameters on day 1 were 5.3 mm in those receiving diclofenac and 4.6 mm in those not (p = 0.003).


CONCLUSIONS
Diclofenac improves the maintenance of per-operative mydriasis, in the presence of irrigating solutions containing adrenaline.
Antcliff
R J
RJ
Department of Ophthalmology, Queen Mary's Hospital Sidcup, Sidcup, Kent, UK.
Trew
D R
DR
D000368:Aged; D000369:Aged, 80 and over; D016861:Cyclooxygenase Inhibitors / Q000494:pharmacology*; D003519:Cyclopentolate / Q000494:pharmacology; D004008:Diclofenac / Q000494:pharmacology*; D004837:Epinephrine / Q000494:pharmacology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009184:Mydriatics / Q000494:pharmacology; D018918:Phacoemulsification; D010656:Phenylephrine / Q000494:pharmacology; D011229:Preanesthetic Medication; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*
D016861:Cyclooxygenase Inhibitors; D009184:Mydriatics; D004008:Diclofenac; D010656:Phenylephrine; D003519:Cyclopentolate; D004837:Epinephrine