Fahmi M S, Arshad Sheikh, Uzma Fasih.
Comparative study of diclofenac sodium with adrenaline for prevention of intra operative miosis.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;10(2):729-31.

Objective: To determined the efficacy of adrenaline, when used in irrigation solution for prevention of preoperative meioses during cataract surgery. Study Design: It is a comparative study. Place and Duration: Study was conducted at Ophthalmology unit of Abbasi Shaheed Hospital from January, 2004 to July 2004. Patients and Methods: One hundred (100) patients were selected, who had cataracts without associated problems. In 50 patients Diclofenac Sodium 1% was used pre operatively 4 times together with tropicanamide 1% eye drops. In other 50 patients only tropicanamide 1% eye drops were used to dilate the pupil. In these patients, adrenaline 1 ml (1:100) diluted in 500 ml of ringers solution was used during surgery. In all these extracapsular cataract extraction with IOL were performed. Pupils were studied at the start and at the end of surgery. Results: Before surgery pupil size was 8mm approximately. At the end of surgery pupil size was 5.5 mm with diclofenac sodium and 6.5 mm in those cases where adrenaline added in irrigation solution. Conclusion: Delivery of the large lens through semidiluted pupils leads to some trauma to the sphincter pupillae which reacts by constriction even in presence of adrenaline and use of diclofenac sodium 1% eye drops. This type of pupillary constriction is less in presence of adrenaline in infusion irrigation solution during surgery.

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