A study on effect of pre-operative topical prednisolone acetate, nepafenac and placebo, on intraoperative mydriasis and its sustenance during cataract surgery: a randomized trial

Background: The objective of the current study was to study the effects of pre-operative use of topical anti-inflammatory prednisolone acetate, nepafenac and placebo, on the sustenance of intraoperative mydriasis during cataract surgery.Methods: This study comprised of 60 patients scheduled for cataract surgery. Patients (20 in each group) were randomized to receive placebo, prednisolone acetate, and nepafenac. These eye drops were given 3 times daily for the 2 days prior to surgery. The pupillary diameters were measured by the surgeon using Casterveijo’s Caliper before the corneal section and at the end of surgery. The primary result was the number of patients with pupil ≥6 mm at the end of the surgery; the secondary result was the number of patients with pupil ≥6 mm at the beginning of the surgery. It was a single-center, masked, randomized clinical study.Results: All the patients achieved pupil ≥6 mm at the beginning of the surgery. The number of patients in the prednisolone (16/20) and nepafenac (17/20) groups with pupil ≥6 mm was greater than in the placebo group in the maintenance of intraoperative mydriasis (7/20 – p=0.003). There was no statistically significant difference among the prednisolone and nepafenac groups in the maintenance of intraoperative mydriasis (p=0.791). There were no complications during surgery or related to the pre-operative use of the eye drops.Conclusion: Pre-operative use of prednisolone acetate and nepafenac was effective in maintaining the intraoperative mydriasis when compared with placebo

Efficacy and safety of travoprost 0.004% compared with tafluprost 0.0015% in patients with primary open-angle glaucoma

Background: This prospective, open, randomized, parallel-group, comparative study is to evaluate the efficacy and side-effect profile of travoprost (TRAV) 0.004% compared with tafluprost (TAF) 0.0015% in patients with primary open-angle glaucoma (POAG) over 12 weeks. A total of 80 patients of POAG selected and were randomized to either TRAV or TAF monotherapy administered once daily in the evening for 12 weeks.Methods: The study was conducted on 80 cases of POAG, in which patients were randomized to either TRAV or TAF monotherapy administered as 1 drop daily in the evening for 12 weeks. Intraocular pressure (IOP) was measured (8 am, 12 noon and 4 pm) at each visit, slit-lamp bio-microscopy was done and side effects noted.Results: The mean IOP reduction in TRAV group decreased from 27.58±2.30 to 19.03±2.326 thus resulting in fall of 8.55 (31.0%) and in TAF group it decreased from 27.38±2.676 to 20.58±2.827 resulting in fall of 6.8 mm Hg (24.8%) was significant (p<0.05). In both treatment groups, the most frequently reported adverse event at 12 weeks was red eye, noted in, 9 (22.5%) and 7 (17.5%) cases of TRAV and TAF groups respectively, though the difference was not statistically significant.Conclusion: TRAV 0.004% monotherapy produced lower diurnal IOP than TAF 0.0015% in patients with POAG and exhibited a similar safety profile

Lacrimal syringing versus combined lacrimal probing and syringing for treatment of congenital nasolacrimal duct obstruction in children

Introduction: Congenital nasolacrimal duct obstruction (CNLDO) is the most common abnormality of the lacrimal system in the early years of life. Aims and Objectives: To rationalize the applicability of lacrimal syringing alone in comparison to combined lacrimal probing and syringing for the treatment of congenital nasolacrimal duct obstruction in children. Material and Methods: The study was conducted on fifty patients suffering from congenital nasolacrimal duct obstruction randomly selected from the outpatient department of Regional Institute of Ophthalmology, Government Medical College, Amritsar. Results: Majority of cases could be cured by single attempt of combined probing and syringing and cure rate could be enhanced by repeated attempts within 1st two years of life. Conclusion: The overall assessment of the study indicates that although the success rate of gentle lacrimal syringing alone is low yet it is worthwhile to try this least traumatic procedure in each and every child reporting with congenital nasolacrimal duct obstruction under 1 year of age. If lacrimal syringing as a first hand procedure fails, then lacrimal probing along with syringing should preferentially be attempted and may be repeated 2-3 times at a minimum interval of 2 weeks each till the patency of nasolacrimal duct is restored