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    Combination therapy targets pupil maintenance, pain

    Take-home: The combination of phenylephrine and ketorolac helped maintain pupil diameter and lowered postoperative pain compared with placebo in patients having cataract surgery in two pooled phase III studies.

    AUSTIN, TEXAS—Patients who received the combination medication phenylephrine/ketorolac (Omidria, Omeros Corp.) during cataract surgery were better able to maintain their pupil diameter during surgery compared with placebo, according to Thomas Walters, MD.

    The investigation looked at the pooled results from 2 phase III randomized, double-masked, placebo-controlled studies including 808 subjects—403 received phenylephrine/ketorolac and 405 received placebo. The study objectives were to measure maintenance of pupil diameter during cataract surgery or refractive lens exchange and postoperative ocular pain during the first 10 to 12 hours after surgery.

    The medication was administered in standard irrigation solution during the procedure, and all subjects in both areas received standard preoperative mydriatic and anesthetic agents.

    Procedure times were categorized as 10 minutes or less, longer than 10 minutes, longer than 12 minutes, longer than 15 minutes, and longer than 20 minutes. Researchers used the mean area under the curve analysis to measure intraoperative change from baseline in pupil diameter (See results in Figure 1) and postoperative subject-reported ocular pain as measured by a Visual Analog Scale (See results in Figure 2, next page).

    Figure 1. Researchers used the mean area under the curve analysis to measure intraoperative change from baseline in pupil diameter.

    All procedures were recorded, and changes in pupil diameter were measured at 1-minute intervals from time of incision to wound closure (end of surgery). A single masked central reader made the measurements.

    Better pupil maintenance

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