Omidria maintains mydriasis during pediatric cataract surger
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There are benefits to using Omidria during pediatric cataract surgery, including in infants, according to a study. Based on the findings from this study, Omidria is the only FDA-approved product for pediatric use as an agent to prevent intraoperative miosis and prevent postoperative pain. Wilson and colleagues assessed the safety of Omidria (phenylephrine 1% and ketorolac 0.3% intraocular solution, Omeros) compared with phenylephrine in children aged 0 to 3 years who were undergoing cataract surgery. The researchers also assessed the effect on postoperative pain and intraoperative pupil diameter.

The multicenter, randomized, double-masked phase 3 clinical trial included 78 patients who received intervention. Depending on randomization, patients received 4 mL of Omidria or phenylephrine 1% in the surgical irrigation solution. Safety endpoints were assessed up to 90 days postoperatively. Thirty-seven eyes underwent primary IOL implantation, with 18 receiving Omidria and 19 receiving phenylephrine. Forty-one eyes were left aphakic at the time of cataract surgery, with 19 receiving Omidria and 22 receiving phenylephrine. Six patients were not included in the final analysis because four patients in the Omidria group and two patients in the phenylephrine group were ineligible to receive the assigned intervention.

However, at 6 hours and 24 hours postoperatively, Omidria provided statistically significant reductions in pain compared with just phenylephrine. While non-preserved epinephrine in the irrigation fluid at surgery has been the standard for pediatric cataract surgery, we now have an FDA-approved product that provides the needed intraoperative pupil size stability of epinephrine but also adds postoperative pain control.