title: Effect of preoperative use of topical prednisolone acetate, ketorolac tromethamine, nepafenac and placebo, on the maintenance of intraoperative mydriasis during cataract surgery: a randomized trial.
abstract: OBJECTIVE
  To compare the effects of preoperative use of topical anti-inflammatory prednisolone acetate, ketorolac tromethamine, nepafenac and placebo, on the maintenance of intraoperative mydriasis during cataract surgery.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  This single-center, masked, randomized clinical study comprised 140 patients scheduled for cataract surgery. Patients (35 in each group) were randomized to receive placebo, prednisolone acetate, ketorolac tromethamine 0.4% or nepafenac. These eye drops were administered three times daily for the two days prior to surgery. The pupillary diameters were measured by the surgeon using a compass prior to the corneal section and at the end of surgery. The primary outcome was the number of patients with pupil ≥ 6mm at the end of the surgery; the secondary outcome was the number of patients with pupil ≥ 6mm at the beginning of the surgery.
  
  
  RESULTS
  All the patients achieved pupil ≥ 6mm at the beginning of the surgery. The number of patients in the prednisolone (29/35), nepafenac (31/35) and ketorolac (30/35) groups with pupil ≥ 6mm was greater than in the placebo group in the maintenance of intraoperative mydriasis (19/35 - P =0.003). There was no statistical difference among the prednisolone, nepafenac and ketorolac groups in the maintenance of intraoperative mydriasis (P =.791). There were no complications during surgery or related to the preoperative use of the eye drops.
  
  
  CONCLUSIONS
  Preoperative use of ketorolac, prednisolone and nepafenac was effective in maintaining intraoperative mydriasis when compared with placebo.
authors: Department of Ophthalmology, State University of Campinas, Rua Irmã Maria David, Recife, PE, Brazil.
authors: Fernando Roberte
authors: FR
authors: Zanetti
authors: Enzo Augusto Medeiros
authors: EA
authors: Fulco
authors: Fernando Rodrigo Pedreira
authors: FR
authors: Chaves
authors: Alexandre Paashaus
authors: AP
authors: da Costa Pinto
authors: Carlos Eduardo Leite
authors: CE
authors: Arieta
authors: Rodrigo Pessoa Cavalcanti
authors: RP
authors: Lira
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D044482:Benzeneacetamides / Q000008:administration & dosage*; D002387:Cataract Extraction / Q000379:methods*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D020911:Ketorolac Tromethamine / Q000008:administration & dosage*; D008297:Male; D015878:Mydriasis / Q000517:prevention & control*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D010648:Phenylacetates / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control*; D011239:Prednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011300:Preoperative Care / Q000379:methods*; D011355:Prodrugs; D012189:Retrospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D044482:Benzeneacetamides; D016861:Cyclooxygenase Inhibitors; D009883:Ophthalmic Solutions; D010648:Phenylacetates; D011355:Prodrugs; C414203:nepafenac; D020911:Ketorolac Tromethamine; C009935:prednisolone acetate; D011239:Prednisolone