BACKGROUND AND PURPOSE: Nonsteroidal antiinflammatory drugs, with antiprostaglandin effect, have been used in the preoperative period of cataract surgery for maintenance of mydriasis during the surgery. Unfortunately, the ideal antiprostaglandin has yet to be introduced. This study is a transversal cut, randomized, placebo-group and double-masked clinical trial comparing the efficacy of ketorolac tromethamine, flurbiprofen sodium and diclofenac sodium with a placebo (hypromellose) in maintaining mydriasis during surgery. METHODS: One hundred sixteen patients, undergoing extracapsular cataract extraction with intraocular lens implantation, were randomly assigned to four groups, which had the same routine for dilation and use of antiprostaglandins. Group I received ketorolac tromethamine; group II, flurbiprofen; group III, diclofenac and group IV, control group, hypromellose. The pupillary data were obtained through an objective questionnaire answered by each surgeon after surgery. RESULTS: Group I was statistically different from placebo regarding maintenance of dilation during surgey. The difference was statistically significant between GI and the other regarding sufficient mydriasis for the beginning of surgery and intraoperative miosis. Flurbiprofen and diclofenac were not statistically different and also when they were compared to the placebo as regards the commented above parameters. CONCLUSIONS: Ketorolac tromethamine was more effective than other antiprostaglandins and placebo considering the tested parameters. Flurbiprofen and diclofenac were better than placebo considering percentual values, with no statistical difference. An increase in the number of our sample as well as other multicentric studies will help to establish a definitive role for antiprostaglandins in maintaining mydriasis during surgery.
Ophthalmic solutions; Cataract extraction; Pupil; Antiinflammatory agents, nonsteroidal; Efficacy; Comparative study; Adult
