Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 2 2 2016 06 13 184 188 EN Mehdi Sanatkar Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran. Mehrdad Goudarzi Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran. Hamed Ghassemi Department of Ophthalmology, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran Mahsa Keyhanian General Physician of Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran Amir Abbas Yaghooti Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran. Hossein Sadrossadat Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran Reza Ghafari Department of Ophthalmology, Tehran University of Medical Sciences, Farabi Eye Hospital, Tehran, Iran. Shahrokh Ghazizadeh Department of Surgery, Tehran University of Medical Sciences, Razi Hospital, Tehran, Iran Hassan Mohammadi Poor Anvari Department of Anesthesiology and Critical Care, Tabriz University of Medical Sciences, Imam Reza Hospital, Tabriz, Iran Somaye Asadi BS Student of Nutrition/Ms Student in Health Management, Tehran University of Medical Sciences, Farabi Eye Hospital,Tehran, Iran 2016 05 16 2016 05 16 Background: Cataract extraction surgery remains the most commonly performed eye surgery by ophthalmologists. The maintenance of mydriasis is required throughout surgery to allow better visualization of the surgical field and a greater working space within the center of the eye. Non-steroidal anti-inflammatory agents (NSAIDs) have their effect in maintaining mydriasis by their ability to inhibit prostaglandin synthesis. Methods: This was a prospective, randomized clinical trial study in 84 patients undergoing phacoemulsification cataract surgery. Patients were randomized to ketorolac tromethamine 0.5% (n=42) or the control group (n=42). Patients in the ketorolac group received one drop of ketorolac every 15 min for a total of 4 drops from one hour before surgery. The horizontal diameters of the pupil were measured in millimeters with a caliper under the microscope at the following stages: before surgery, after intracameral epinephrine injection, after nuclear emulsification and at the end of surgery. Results: The difference in pupillary diameter at the end of surgery was statistically significant between two groups (7.34 ± 1.0 mm and 8.01 ±0.67 mm in the control and the ketorolac groups, respectively; p=0.018). The difference in mean pupil size after intracameral epinephrine injection and after nuclear emulsification between the control group (0.51 ± 0.25 mm) and the ketorolac group (0.01 ± 0.20 mm) was statistically significant (p <0.001). Moreover, the difference in mean pupil size after intracameral epinephrine injection and at the end of surgery between the control group (0.79 ± 0.44 mm) and the ketorolac group (0.19 ± 0.23 mm) was statistically significant (p <0.001). There was no difference in maintaining mydriasis between diabetic patients and non-diabetic patients. Conclusion: Topical ketorolac is an effective inhibitor of miosis during phacoemulsification cataract surgery, and provides a more stable mydriatic effect throughout the surgical procedure. https://aacc.tums.ac.ir/index.php/aacc/article/view/76 https://aacc.tums.ac.ir/index.php/aacc/article/download/76/174