Randomised controlled single-blind study of conventional versus depot mydriatic drug delivery prior to cataract surgery.
BACKGROUND
A prerequisite for safe cataract surgery is an adequately dilated pupil. The authors conducted a trial to assess the efficacy (in terms of pupil diameter) of a depot method of pre-operative pupil dilatation, as compared with repeated instillations of drops (which is time-consuming for the nursing staff and uncomfortable for the patient).


METHODS
A prospective randomised masked trial was conducted comprising 130 patients with no significant ocular history undergoing elective clear corneal phacoemulsification. 65 patients had mydriatic drops (Tropicamide 1%, Phenylephrine 2.5%, Diclofenac sodium 0.1%) instilled prior to surgery, 65 had a wick soaked in the same drop mixture placed in the inferior fornix. Horizontal pupil diameters were recorded on a millimetre scale immediately prior to surgery.


RESULTS
There was no significant difference in pupil size between the two groups (p = 0.255, Student's t-test).


CONCLUSIONS
There was no significant difference between the mydriasis obtained with the depot system compared with conventional drop application. Use of a depot mydriatic delivery system appears to be a safe and efficient method of drug delivery.


BACKGROUND
International Standard Randomised Controlled Trial Number Register ISRCTN78047760.
Dubois
Vincent
V
Eye Unit, Royal United Hospital, Combe Park, Bath, B&NES, BA1 3NG, UK. vincent_dubois@doctors.org.uk
Wittles
Nadia
N
Lamont
Meon
M
Madge
Simon
S
Luck
Jon
J
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D004008:Diclofenac / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D018918:Phacoemulsification; D010656:Phenylephrine / Q000008:administration & dosage; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects*; D016037:Single-Blind Method; D016896:Treatment Outcome; D014331:Tropicamide / Q000008:administration & dosage
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003692:Delayed-Action Preparations; D009184:Mydriatics; D009883:Ophthalmic Solutions; D004008:Diclofenac; D010656:Phenylephrine; D014331:Tropicamide