Comparison of Preoperative Topical Dexamethasone Phosphate Versus Ketorolac Tromethamine in Maintaining Intraoperative Mydriasis During Small Incision Cataract SurgeryCorrespondence Address :
Dr. Ashok Kumar Sharma,
67/1, Channi Himmat, Jammu, Jammu and Kashmir - 180015, India.
Introduction: Intraoperative miosis is one of the many challenges which a surgeon can face during cataract surgery. It may leads to impaired view and difficulty in delivering the nucleus. Also, it increases the chances of more serious intraoperative and postoperative complications. Therefore, maintaining adequate pupillary dilatation is of utmost importance during cataract surgery.
Aim: To study the efficacy of topical dexamethasone phosphate (0.1%) and topical ketorolac tromethamine (0.4%) in maintaining pupillary dilatation during cataract surgery.
Materials and Methods: A total of 200 patients were studied. These were randomly divided into two groups of 100 each. Group1 was given topical dexamethasone phosphate (0.1%) and Group 2, topical ketorolac tromethamine (0.4%). Medications were started 1-day before surgery in the form of one drop to be instilled every 6 hours. Pupillary diameter was measured in the horizontal meridian; 4 readings were taken - before making the incision, after nucleus delivery, following cortical clean-up and after Intraocular Lens (IOL) implantation.
Results: The two drugs showed no statistically significant difference in pupillary diameter at the commencement of surgery (p=0.435). The difference between the two drugs was statistically significant, for the mean pupillary diameter which changed from the start of surgery to after cortical clean-up. At this stage, ketorolac group showed a tendency towards larger mean pupillary diameter than dexamethasone group (6.70 ± 0.85mm and 6.32 ± 0.84mm, respectively, p=0.002). Again, ketorolac group patients had larger pupillary diameter after IOL implantation than dexamethasone group patients (the mean was 6.16± 0.97mm and 5.75 ± 0.73mm, respectively, p=0.001).
Conclusion: Both ketorolac tromethamine (0.4%) and dexamethasone phosphate (0.1%) are effective in maintaining adequate mydriasis during cataract surgery, but the comparative analysis of the two drugs concludes that, ketorolac is definitely a better option in preventing surgically induced miosis.
Corticosteroids, Miosis, Non-steroidal anti-inflammatory drugs
Ashok Kumar Sharma, Hans Raj Sharma, Rajni Sharma, Amrita Singh. COMPARISON OF PREOPERATIVE TOPICAL DEXAMETHASONE PHOSPHATE VERSUS KETOROLAC TROMETHAMINE IN MAINTAINING INTRAOPERATIVE MYDRIASIS DURING SMALL INCISION CATARACT SURGERY. Journal of Clinical and Diagnostic Research [serial online] 2016 May [cited: 2018 Sep 19 ]; 10:NC09-NC13. Available from
Date of Submission: Feb 17, 2016
Date of Peer Review: Mar 16, 2016
Date of Acceptance: Apr 06, 2016
Date of Publishing: May 01, 2016
Financial OR OTHER COMPETING INTERESTS: None.
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