September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
A comparison of the frequency of use of the Malyugin ring with & without intracameral phenylephrine & ketorolac 1%/0.3%(phenyl/keto) injection at the time of routine cataract surgery
Author Affiliations & Notes
  • Frank A Bucci
    Bucci Laser Vision Institute, Wilkes Barre, Pennsylvania, United States
  • Angel Fluet
    Bucci Laser Vision Institute, Wilkes Barre, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Frank Bucci, None; Angel Fluet, None
  • Footnotes
    Support  Consultant for Omeros
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1299. doi:
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      Frank A Bucci, Angel Fluet; A comparison of the frequency of use of the Malyugin ring with & without intracameral phenylephrine & ketorolac 1%/0.3%(phenyl/keto) injection at the time of routine cataract surgery. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1299.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate if use of phenyl/keto will decrease the need of the Malyugin ring used for small pupils during cataract surgery.

Methods : A retrospective, single-center, single-surgeon analysis of 1185 cataract surgeries was performed analyzing the frequencies of use of the Malyugin ring with & without the commercial product phenyl/keto.
The frequency of use of the Malyugin ring was analyzed in 668 consecutive cases prior to Feb 2015 when phenyl/keto was not used (control group), and in 517 consecutive cases performed after Mar 2015 when phenyl/keto was used (treatment group).
All patients who presented for & underwent cataract surgery during the study’s duration were included in the analysis. During the period when the control cases were performed, intracameral injections of epinephrine were selectively used in cases with IFIS or poorly dilating pupils as determined by the surgeon. During the period when the treatment cases were performed, intracameral epinephrine was not used. All intracameral injections were performed just prior to the use of a viscoelastic in preparation for the capsulotomy (just prior to the decision point regarding the use of the Malyugin ring).
A grouped t-test was used to statistically analyze differences in the frequency of use of the Malyugin ring between the control & the treatment groups.

Results : In the 668 cases performed in the control group prior to Feb 2015 without phenyl/keto the surgeon chose to use the Malyugin ring 55 times (8.23%). In the 517 cases performed in the treatment group after Mar 2015, the surgeon chose to use the Malyugin ring 14 times (2.70%)(p=0.0001). There was no sig diff between the groups in the % of cases where a femtosecond laser was used during the surgery (22.61% control group vs. 17.80% treatment group).

Conclusions : The frequency of use of the Malyugin ring was significantly reduced from 8.23% in the control group to 2.70% (a more than three-fold difference) in the treatment group receiving phenyl/keto injection 1%/0.3% across a patient population representative of the surgeon’s diverse practice of routine & complex cases. The results of this study strongly suggest that the anti-miotic/anti-inflammatory effects of phenyl/keto injection 1%/0.3% reduced both facility costs related to Malyugin ring use & associated patient risks of intraocular injury.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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