Topical administration of diclofenac (1%) in the prevention of miosis during vitrectomy.

Abstract

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. 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. 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). 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.