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.
RCT Entities:
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.
Authors: Rafael B de Araújo; Breno M S Azevedo; Thais S Andrade; Maria F Abalem; Mário L R Monteiro; Pedro C Carricondo Journal: Int J Retina Vitreous Date: 2018-10-17