TOPICAL 0.5-PERCENT KETOROLAC VS 0.03-PERCENT FLURBIPROFEN FOR INHIBITION OF MIOSIS DURING CATARACT-SURGERY

Objective: To compare the effects of topical 0.5% ketorolac tromethami ne ophthalmic solution (Acular, Allergen Pharmaceuticals, Irvine, Cali f) with topical 0.03% flurbiprofen sodium ophthalmic solution (Ocufen, Allergen Pharmaceuticals) on the inhibition of surgically induced mio sis during phacoemulsification cataract surgery. Design: One hundred e ighteen patients were prospectively randomized to receive 0.5% topical ketorolac or 0.03% topical flurbiprofen at 3 preoperative intervals. The flurbiprofen-treated group served as the control group. The surgeo n was masked as to patient selection. Horizontal pupillary diameter me asurements were obtained at the start of surgery, just before phacoemu lsification, before lens implantation, and after lens implantation. Re sults: Mean horizontal pupillary diameter measurements for both medica tions were similar at the start of surgery. However, a consistent tren d of larger pupillary diameter was seen in all subsequent surgical int ervals in the ketorolac-treated group. Changes from baseline measureme nts also indicated a more significant inhibition of miosis at all subs equent intervals, and a more stable mydriasis throughout the procedure in the ketorolac-treated group. Conclusions: Topical ketorolac is an effective inhibitor of miosis during phacoemulsification cataract surg ery, and provides a more stable mydriatic effect throughout the surgic al procedure.