EFFECT OF TROPICAMIDE VERSUS TROPICAMIDE AND NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) ON MAINTAINING MYDRIASIS IN CATARACT SURGERY

Abstract

Background: Cataract surgery is one of the most frequently performed ophthalmic procedures globally, with a high success rate in restoring vision. However, the procedure's effectiveness and safety depend significantly on adequate pupil dilation, or mydriasis, which provides the surgeon with a better view of the intraocular structures and allows greater maneuverability for instrument handling. No local research yet on Pakistani patients with pigmented irises.

Aim: To compare the effectiveness of prophylactic administration of topical tropicamide 1% alone with combination of topical tropicamide 1% and nepafenac 0.1% in maintaining mydriasis during cataract surgery

Methods: The Randomized controlled trial was conducted at Ophthalmology Unit-I, Mayo Hospital, Lahore from February 27, 2024 to August 26, 2024. Total of 154 patients having senile cataract undergoing phacoemulsification were selected. Patients were divided in two groups. One group (T-Group) received 1 drop of 1% tropicamide every 15 mins 1 hour before surgery and other group (TN-Group) got 1 drop of 1% tropicamide and 0.1% nepafenac combination in the same manner. Before starting surgery, pupil diameter 6mm vertically and 6mm horizontally was regarded as effective mydriasis. Analysis was carried out through SPSS 26.0 v. Comparison of effective mydriasis between two groups was checked by Chi-square test. P-value ≤0.05 was taken as significant.

Results: The mean ages of patients in group-T were 51.38±10.28 years and in group-TN, mean age was 51.68±10.13 years. The mean pupil diameter in group-T was 6.5±2.3 mm and in group-TN, mean diameter was 6.9±2.6 mm. According to maintaining effective mydriasis distribution, in group-T, 37(48.1%) maintained effective mydriasis, while in Group-TN, 53(68.8%) maintained effective mydriasis with a p-value 0.009.

Conclusion: The findings from this study suggest that the combination of tropicamide and nepafenac is more effective in maintaining mydriasis throughout the duration of cataract surgery than tropicamide alone.