Comparison of preoperative topical dexamethasone phosphate versus ketorolac tromethamine in maintaining intraoperative mydriasis during small incision cataract surgery – a one year randomized control trial at kles dr. prabhakar kore hospital and medical research centre, belagavi

Abstract

BACKGROUND: Cataract is the leading cause of impaired vision in the elderly population all over the world next only to refractive error. It is caused due to the opacification of the transparent lens of the eye. Senile cataracts can be a nuclear cataract, a cortical cataract or a posterior subcapsular cataract. Based on the cause, they can be complicated cataracts or uncomplicated cataracts. Surgical treatment for senile cataracts includes an Extra Capsular Cataract Extraction(ECCE) in its modified advanced form called Small Incision Cataract Surgery(SICS) or Phacoemulsification surgery. Due to its various advantages like incision size, easy availability, technical compliance, cheaper cost etc , SICS is used more comfortably in treating senile cataracts especially in developing countries like India. In the procedure of SICS the delivery of the nucleus and cortical matter removal are the most significant steps that requires an adequate pupillary size for their uninterrupted complete removal. Maintaining adequate pupillary size is of utmost importance for a successful surgery. Intraoperative miosisis thought to be caused by the Prostaglandins (PGs), Leukotrienes (LTs) and other inflammatory mediators released during surgical trauma. Currently, Topical Non Steroidal Anti-Inflammatory Drugs(NSAIDs) and Steroids are being used preoperatively in order to prevent the release of PGs and LTs and to maintain intraoperative mydriasis. The efficiency of these two classes of drugs needs to be compared so that the best drug can be given preoperatively.