Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®)
<h3>Purpose</h3><p dir="ltr">This systematic review and meta-analysis aims to evaluate the efficacy and safety of the combination of phenylephrine 1% and ketorolac 0.3% (OMIDRIA®) for optimizing pain management and maintaining pupil dilation during cataract surgery. Compa...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , , |
| منشور في: |
2025
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| الموضوعات: | |
| الوسوم: |
إضافة وسم
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| _version_ | 1864513534644191232 |
|---|---|
| author | Mohamed Abo Zeid (20020680) |
| author2 | Amr Elrosasy (20020683) Kareem Khalefa (22466368) Mohamed Elhadary (16329082) Shrouk F. Mohamed (22466371) Amr Elkelany (22466374) Hashem Abu Serhan (15993651) |
| author2_role | author author author author author author |
| author_facet | Mohamed Abo Zeid (20020680) Amr Elrosasy (20020683) Kareem Khalefa (22466368) Mohamed Elhadary (16329082) Shrouk F. Mohamed (22466371) Amr Elkelany (22466374) Hashem Abu Serhan (15993651) |
| author_role | author |
| dc.creator.none.fl_str_mv | Mohamed Abo Zeid (20020680) Amr Elrosasy (20020683) Kareem Khalefa (22466368) Mohamed Elhadary (16329082) Shrouk F. Mohamed (22466371) Amr Elkelany (22466374) Hashem Abu Serhan (15993651) |
| dc.date.none.fl_str_mv | 2025-03-29T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1007/s00417-025-06811-y |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Optimizing_pain_management_and_pupil_dilation_in_cataract_surgery_a_systematic_review_and_meta-analysis_of_phenylephrine_ketorolac_OMIDRIA_/30405355 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Cataract surgery Ketorolac Phenylephrine Postoperative pain Pupil dilation |
| dc.title.none.fl_str_mv | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®) |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Purpose</h3><p dir="ltr">This systematic review and meta-analysis aims to evaluate the efficacy and safety of the combination of phenylephrine 1% and ketorolac 0.3% (OMIDRIA®) for optimizing pain management and maintaining pupil dilation during cataract surgery. Comparisons were made against placebo/vehicle, phenylephrine alone, and epinephrine.</p><h3>Methods</h3><p dir="ltr">A comprehensive search of PubMed, Cochrane CENTRAL, Embase, Scopus, and Web of Science was conducted. Eligible studies were randomized clinical trials and observational studies assessing intracameral phenylephrine/ketorolac against control groups. Key outcomes included pain management, pupil diameter, and adverse events. Data were synthesized using meta-analysis with fixed and random-effects models, and heterogeneity was assessed using the I<sup>2</sup> statistic.</p><h3>Results</h3><p dir="ltr">Ten studies, including 220,061 patients, were analyzed. The combination of phenylephrine/ketorolac significantly reduced postoperative pain (RR = 0.72, 95% CI: 0.60–0.86) and opioid use (RR = 0.45, 95% CI: 0.23–0.89) compared to vehicle and epinephrine. PE/K also maintained a larger pupil diameter (MD = 0.54 mm, 95% CI: 0.32–0.75) with minimal heterogeneity (I<sup>2</sup> = 0%) and reduced the incidence of severe pain (RR = 0.41, 95% CI: 0.27–0.63). No significant differences in adverse events such as elevated intraocular pressure, inflammation, or headaches were observed.</p><h3>Conclusion</h3><p dir="ltr">Phenylephrine/ketorolac (OMIDRIA®) demonstrates superior efficacy in maintaining intraoperative mydriasis, reducing postoperative pain, and minimizing opioid use without increasing adverse events. This combination offers a preferable alternative to traditional agents, potentially setting a new standard for pain management and pupil dilation in cataract surgery.</p><h2>Other Information</h2><p dir="ltr">Published in: Graefe's Archive for Clinical and Experimental Ophthalmology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00417-025-06811-y" target="_blank">https://dx.doi.org/10.1007/s00417-025-06811-y</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_084926ac9b4d4bf1344a75e866a7b076 |
| identifier_str_mv | 10.1007/s00417-025-06811-y |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/30405355 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®)Mohamed Abo Zeid (20020680)Amr Elrosasy (20020683)Kareem Khalefa (22466368)Mohamed Elhadary (16329082)Shrouk F. Mohamed (22466371)Amr Elkelany (22466374)Hashem Abu Serhan (15993651)Biomedical and clinical sciencesClinical sciencesCataract surgeryKetorolacPhenylephrinePostoperative painPupil dilation<h3>Purpose</h3><p dir="ltr">This systematic review and meta-analysis aims to evaluate the efficacy and safety of the combination of phenylephrine 1% and ketorolac 0.3% (OMIDRIA®) for optimizing pain management and maintaining pupil dilation during cataract surgery. Comparisons were made against placebo/vehicle, phenylephrine alone, and epinephrine.</p><h3>Methods</h3><p dir="ltr">A comprehensive search of PubMed, Cochrane CENTRAL, Embase, Scopus, and Web of Science was conducted. Eligible studies were randomized clinical trials and observational studies assessing intracameral phenylephrine/ketorolac against control groups. Key outcomes included pain management, pupil diameter, and adverse events. Data were synthesized using meta-analysis with fixed and random-effects models, and heterogeneity was assessed using the I<sup>2</sup> statistic.</p><h3>Results</h3><p dir="ltr">Ten studies, including 220,061 patients, were analyzed. The combination of phenylephrine/ketorolac significantly reduced postoperative pain (RR = 0.72, 95% CI: 0.60–0.86) and opioid use (RR = 0.45, 95% CI: 0.23–0.89) compared to vehicle and epinephrine. PE/K also maintained a larger pupil diameter (MD = 0.54 mm, 95% CI: 0.32–0.75) with minimal heterogeneity (I<sup>2</sup> = 0%) and reduced the incidence of severe pain (RR = 0.41, 95% CI: 0.27–0.63). No significant differences in adverse events such as elevated intraocular pressure, inflammation, or headaches were observed.</p><h3>Conclusion</h3><p dir="ltr">Phenylephrine/ketorolac (OMIDRIA®) demonstrates superior efficacy in maintaining intraoperative mydriasis, reducing postoperative pain, and minimizing opioid use without increasing adverse events. This combination offers a preferable alternative to traditional agents, potentially setting a new standard for pain management and pupil dilation in cataract surgery.</p><h2>Other Information</h2><p dir="ltr">Published in: Graefe's Archive for Clinical and Experimental Ophthalmology<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1007/s00417-025-06811-y" target="_blank">https://dx.doi.org/10.1007/s00417-025-06811-y</a></p>2025-03-29T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1007/s00417-025-06811-yhttps://figshare.com/articles/journal_contribution/Optimizing_pain_management_and_pupil_dilation_in_cataract_surgery_a_systematic_review_and_meta-analysis_of_phenylephrine_ketorolac_OMIDRIA_/30405355CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/304053552025-03-29T09:00:00Z |
| spellingShingle | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®) Mohamed Abo Zeid (20020680) Biomedical and clinical sciences Clinical sciences Cataract surgery Ketorolac Phenylephrine Postoperative pain Pupil dilation |
| status_str | publishedVersion |
| title | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®) |
| title_full | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®) |
| title_fullStr | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®) |
| title_full_unstemmed | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®) |
| title_short | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®) |
| title_sort | Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine/ketorolac (OMIDRIA®) |
| topic | Biomedical and clinical sciences Clinical sciences Cataract surgery Ketorolac Phenylephrine Postoperative pain Pupil dilation |