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Omidria maintains pupil size during femtosecond cataract surgery

Issue: May 25, 2018

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WASHINGTON — Phenylephrine and ketorolac intraocular solution either maintained or increased pupil dilation through femtosecond laser-assisted cataract surgery, according to a speaker here.

While femtosecond laser-assisted surgery has many advantages, it is also associated with the formation of prostaglandins, which leads to intraoperative pupil miosis, Johnny L. Gayton, MD, said in a paper presentation at the American Society of Cataract and Refractive Surgery meeting.

“Pre-emptive use of a product to decrease prostaglandin formation and maintain intraoperative mydriasis would be beneficial in this setting,” he said.

A retrospective case review of 77 cataract surgery patients who were given intraoperative Omidria (phenylephrine 1% and ketorolac 0.3% intraocular solution, Omeros) at the beginning of the case found decreased prostaglandin formation and maintenance of pupil size during the operation, according to Gayton.

A total of 57 patients had traditional phacoemulsification surgery and 20 underwent femtosecond laser-assisted cataract surgery.

Mean pupil diameter in the phacoemulsification group was 6.65 mm at baseline, which increased to 7.42 mm at the time of IOL insertion. In the femtosecond laser-assisted surgery group, mean pupil diameter increased from 6.69 mm at baseline to 7.65 mm at time of IOL insertion.

“The intracameral phenylephrine/ketorolac solution during traditional surgery and during femtosecond laser surgery did not only enable us to have a pupil that was maintained, but that actually dilated,” Gayton said. – by Rebecca L. Forand

Reference:

Gayton J. Effect of early phenylephrine and ketorolac injection 1%/0.3% on pupil diameter in traditional and femtosecond laser assisted cataract surgery. Presented at: American Society of Cataract and Refractive Surgery annual meeting; April 13-17, 2018; Washington.

Disclosure: Gayton reports he is a consultant for Omeros.