Nepafenac-assisted mydriasis in a rabbit model

PurposeTo compare the effectiveness of nepafenac 0.10% in achieving and maintaining pupil dilation with the effectiveness of flurbiprofen 0.03% and a placebo in a rabbit model.SettingDepartment of Ophthalmology, University of California, San Francisco, California, USA.DesignLaboratory study.MethodsAdult pigmented rabbits were randomized to 3 equal-sized groups: placebo, flurbiprofen, and nepafenac. Cataract surgery was performed in randomized order by a surgeon who was masked to group assignment. The treatment or placebo was administered starting 1 day before surgery. Phenylephrine 10.0% was administered starting 30 minutes before surgery. Phacoemulsification was performed in standard fashion. Pupil measurements were recorded before and after surgery. A linear mixed model with a random effect for the rabbits and a fixed effect for the treatment groups was used to compare mean pupil diameters between groups.ResultsBaseline pupil measurements were similar between the placebo, flurbiprofen, and nepafenac groups. Preoperative pupil dilation was statistically significantly greater in the nepafenac group (mean 11.5 mm ± 0.5 [SD]) than in the placebo group (mean 10.2 ± 1.1 mm) and the flurbiprofen group (mean 9.9 ± 1.1 mm) (P<.005 and P<.001, respectively). The greater dilation was maintained at the end of surgery, at which time the nepafenac group had statistically significantly larger pupils (mean 9.4 ± 1.2 mm) than the placebo group (mean 7.9 ± 0.6 mm) and the flurbiprofen group (mean 8.5 ± 0.9 mm) (P<.001 and P<.05, respectively).ConclusionNepafenac was more effective than a placebo and flurbiprofen in achieving maximum preoperative and postoperative pupil mydriasis in rabbits.Financial DisclosureNo author has a financial or proprietary interest in any material or method mentioned.