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KULSHRESTHA MANOJ K. FRCSI; RAUZ, SAAEHA FRCO; GOBLE, RICHARD R. FRCO; STAVRAKAS, IOANNIS A. MRCO, FRCS, DEBO; KIRKBY, GRAHAM R. DO, FRCS, FRCO
Retina: January 2000
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Purpose: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 subconjunc-tival 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 < 4.7 × 10-06).

Conclusion: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.

From *Birmingham & Midland Eye Centre and †University of Birmingham, UK; ‡Ipswich, UK; and §Vasilissis, Athens, Greece.

Presented as a poster at the annual meeting of the Association for Research in Vision and Ophthalmology; Fort Lauderdale, Florida; May 1997.

Reprint requests: Manoj Kulshrestha, FRCSI, Specialist Regis-trar in Ophthalmology. Birmingham and Midland Eye Centre, City Hospital NHS Trust. Dudley Road, Birmingham B18 7QU, UK.

© 2000 by Ophthalmic Communications Society, Inc.