EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/555047
In a phase 2b clinical trial, OMIDRIA was 4 to 6 times more effective in preventing pupil diameter of < 6 mm than intracameral phenylephrine or ketorolac. 2 FDA-approved OMIDRIA is added to the irrigation solution used during cataract surgery and lens replacement for direct and continuous intracameral delivery of mydriatic and NSAID therapy. 1 In pivotal phase 3 clinical trials (N=808) in which all patients received standard topical mydriatics preoperatively, OMIDRIA was superior to placebo across all assessments of pupil size. In fact, 96% of OMIDRIA-treated patients had pupil diameter ≥ 6 mm at the time of lens implantation. 1,2,5 0 p<0.0001 p=0.0004 p<0.0216 10 20 30 40 50 Vehicle (n=53) Ketorolac (n=52) Phenylephrine (n=49) OMIDRIA (n=49) 46% 35% 22% 6% Patients (%) Percent of patients with pupil diameter <6 mm at any time during surgery 2, * 0 Placebo (n=180) OMIDRIA (n=184) Placebo (n=180) OMIDRIA (n=195) p<0.0001 10 20 30 40 Study 1 Study 2 Patients (%) Pupil diameter <6 mm at start of lens implantation 2,5 What you can expect with OMIDRIA ® (phenylephrine and ketorolac injection) 1% / 0.3% Post hoc analysis 100% of patients receiving topical ketorolac preoperatively had nominal or undetectable ketorolac levels at the end of the procedure. 6,† 4% 4% 23% 23% In two pivotal phase 3 clinical trials § in which all patients received standard anesthetic agents preoperatively, patients treated with OMIDRIA were: Ketorolac tissue levels inhibited COX-1 and COX-2 pathways for at least 10 hours postoperatively 7,8 0 20 40 60 80 100 0 Retinal COX-1 Retinal COX-2 2 6 Time postsurgery (hr) 8 10 Estimated inhibition (%) 50% 50% 30% more likely to be pain-free up to 12 hours after surgery 9 less likely to use analgesics on day of surgery 9 less likely to have moderate- to-severe pain 9 and… Topical ketorolac may not go the distance. In fact, in a study evaluating the presence of preoperative topical ketorolac at the end of cataract surgery: TOPICAL MEDICATIONS CAN WASH OUT 6 OMIDRIA is delivered in the irrigation solution continuously during surgery. In a study of conventional phacoemulsifi cation and lens replacement performed with OMIDRIA in 20 canines, ketorolac levels measured throughout the structures of the eye were suffi cient to ablate COX-1 and -2 pathways for at least 10 hours postoperatively. 7,8,‡ SUPERIOR TO PHENYLEPHRINE OR KETOROLAC ALONE* WITH OMIDRIA, NSAID LEVELS MAINTAINED THROUGHOUT SURGERY 1 OMIDRIA EFFECTIVELY REDUCES POSTOPERATIVE OCULAR PAIN 1 CONSISTENTLY MAINTAINS PUPIL DIAMETER 2,5