title: The role of preoperative subconjunctival mydricaine and topical diclofenac sodium 0.1% in maintaining mydriasis during vitrectomy.
abstract: OBJECTIVE
  To establish the role of preoperative subconjunctival mydricaine and diclofenac 0.1% in maintaining mydriasis during vitrectomy.
  
  
  METHODS
  Fifty-seven patients were entered into the study. All were given cyclopentolate 1% and phenylephrine 2.5% preoperatively. Each patient was randomly allocated to one of three groups. In Group 1, patients received mydricaine by subconjunctival injection and diclofenac 0.1% topically preoperatively. In Group 2, patients received only subconjunctival mydricaine. Group 3 patients received only topical diclofenac preoperatively. Pupil diameter was measured with calipers before and at the end of the operation.
  
  
  RESULTS
  There was no statistically significant difference in the change in pupil size between Groups 2 and 3. In all patients in Group 1 (who received both subconjunctival mydricaine and diclofenac preoperatively), pupil size was either maintained or increased after vitrectomy. This result was statistically significant when compared with the other groups (for Group 1 versus Group 2, P<0.005; for Group 1 versus Group 3, P<4.7x10(-06)).
  
  
  CONCLUSIONS
  Topical diclofenac is useful for maintaining pupil size during vitrectomy only when used in conjunction with subconjunctival mydricaine, especially in patients in whom prolonged surgery is anticipated.
authors.affiliation: Birmingham & Midland Eye Centre, Birmingham, UK.
authors.forename: M K
authors.initials: MK
authors.lastname: Kulshrestha
authors.forename: S
authors.initials: S
authors.lastname: Rauz
authors.forename: R R
authors.initials: RR
authors.lastname: Goble
authors.forename: I A
authors.initials: IA
authors.lastname: Stavrakas
authors.forename: G R
authors.initials: GR
authors.lastname: Kirkby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001285:Atropine / Q000008:administration & dosage; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage*; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007267:Injections; D007498:Iris / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D011300:Preoperative Care; D011343:Procaine / Q000008:administration & dosage; D011680:Pupil / Q000187:drug effects*; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D016861:Cyclooxygenase Inhibitors; D004338:Drug Combinations; D009184:Mydriatics; D009883:Ophthalmic Solutions; D004008:Diclofenac; D011343:Procaine; D001285:Atropine; D004837:Epinephrine