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TOPICAL ADMINISTRATION OF DICLOFENAC (1%) IN THE PREVENTION OF MIOSIS DURING VITRECTOMY

MIRSHAHI, AHMAD MD*; DJALILIAN, ALI MD; RAFIEE, FERESHTE MD*; NAMAVARI, ABED MD

doi: 10.1097/IAE.0b013e31817b6afa
Original Articles
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Purpose: A prospective, randomized clinical trial was conducted to assess the usefulness of preoperative diclofenac eye drops in maintaining mydriasis during vitrectomy and in reducing postoperative inflammation.

Methods: Fifty consecutive patients undergoing vitrectomy were randomly assigned to diclofenac (n = 24) or control (n = 26) groups. All patients received a standard preoperative regimen of cyclopentolate (2%) and phenylephrine hydrochloride (2.5%). The diclofenac group also received diclofenac (1%) preoperatively. Pupillary diameter was recorded at four time points during surgery. Inflammatory indices were measured postoperatively using slit-lamp examination.

Results: After induction of anesthesia, the decrease in pupil size was not significantly different between the two groups (P = 0.112), but for the next two stages, it was significantly less in the diclofenac group (P = 0.012 and P = 0.003, respectively). No significant differences were found between the two groups for anterior chamber cells and redness in the eye postoperatively (P = 0.609 and P = 0.123, respectively). However, anterior chamber flare was significantly greater in the control group (P = 0.035), and patients felt significantly more pain in this group (P = 0.001).

Conclusions: Topical administration of diclofenac was effective in maintaining mydriasis during vitrectomy and in reducing postoperative pain and anterior chamber flare as determined by slit-lamp evaluations.

Topical administration of diclofenac was effective in preventing miosis during vitrectomy and in reducing postoperative eye pain and anterior chamber flare as detected by slit-lamp examination.

From the *Department of Ophthalmology, Tehran University of Medical Sciences Eye Research Center, Tehran, Iran; and the †Department of Opthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.

None of the authors have a financial interest in the drugs listed in this article.

Reprint requests: Abed Namavari, MD, Department of Opthalmology and Visual Sciences, University of Illinois at Chicago, 1926 West Harrison Street, Number 1500, Chicago, IL 60612; e-mail: abednamavari@yahoo.com

© The Ophthalmic Communications Society, Inc.