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   Table of Contents      
ARTICLES
Year : 1985  |  Volume : 33  |  Issue : 2  |  Page : 89-90

Role of aspirin in cataract surgery


Department of Opthalmology Rangaraya Medical College, Kakinada, India

Correspondence Address:
K N Chinnayya Rao
Rangaraya Medical College, Kakinada. (AP.)
India
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Source of Support: None, Conflict of Interest: None


PMID: 3833741

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How to cite this article:
Chinnayya Rao K N, Rao M V. Role of aspirin in cataract surgery. Indian J Ophthalmol 1985;33:89-90

How to cite this URL:
Chinnayya Rao K N, Rao M V. Role of aspirin in cataract surgery. Indian J Ophthalmol [serial online] 1985 [cited 2019 Nov 14];33:89-90. Available from: http://www.ijo.in/text.asp?1985/33/2/89/30827

Miosis induced by surgical trauma is a common problem during round pupil cataract extraction in spite of the preoperative use of mydriatics. The pupil constricts soon after the sclerocorneal section is made. Post operative uveitic exudation in the anterior chamber is also observed many a time.

It was noted more than twenty years ago that stimulation studies of the fifth nerve resulted in miosis which could not be blocked with atropine[1], Ambache[2] showed that extracts of iris contained a smooth muscle stimulating substance to which he gave the name irin. It was later demonstrated irin infact contained Prostaglandins. There is a strong evidence that Prostaglandins are at least partly responsible for the miosis in cataract surgery. Indomethacin and phenyl­butazone are drugs of similar action The effect of indomethacin in preventing surgically induced miosis has been studied and reported[6],[7].

Pretreatment with Aspirin significantly decreased trauma induced (probably Prosta­glandin mediated) infusion of proteins into the anterior chamber of patients undergoing Cataract extraction[8]. Both Asprin and Indo­methacin have been shown to produce signi­ficant reduction in the acute ocular hyperten­sion which can be expected to follow six hours after routine Cataract surgery[9].

We have studied the effect of the preopera­tive treatment with Aspirin (in Comparison with a Control group) in preventing the surgically induced miosis during Cataract extraction.


  Materials and methods Top


72 Patients with senile cataract were operated. They are in the age group of 50-70 years. They are divided into two groups A group which received preopera­tive Aspirin and a group which did not receive the drug-control group. Previous history of peptic ulcer or hyperacidity was carefully elicited in each case. Those cases with a definite history or doubtful history were excluded from this study.

On the night before surgery Aspirin 600 mg was administered in the form of tablets preceded by an antacid. A second dose of Aspirin 600 mg was given with an antacid 2 hours prior to surgery. No mydriatic was used. Sclerocorneal section was performed with Keratome and Corneal Scissors. Peri­pheral button hole iridectomy was done. Cataractous lens was extracted using a cryo­probe.


  Observations Top


The pupillary diameter was measured using a Caliper-Before ciliary block-after Ciliary block, soon after section, after extraction of lens.

It was noted that pupil showed a sustained dilatation during surgery permitting a comfor­table extraction of lens in the aspirin pretrea­ted group than in the control group. The pupillary constriction during the operation was less in the aspirin pretreated group(Mean pupillary constriction 1.25 mm) than in the control group.

The post operative period was uneventful in all the cases which received preoperative aspirin. In the control group 30% cases developed mild uveitic exudation into the pupillary region which has cleared after 3 days of administering Atropine and Corticosteroids.


  Discussion Top


In this study the pre-operative treatment with Aspirin compared with a control group significantly inhibited miosis during cataract extraction. Post operative reaction of the uveal tissue is much less. It was established that prostaglandins are released in the iris and ciliary body in response to trauma and give rise to the irritative response of miosis, rise of intraocular pressure etc.[3],[9].

From experimental studies it was found that these effects could be suppressed by treatment with prostaglandin synthetase inhibitors[3],[4],[10],[11]. In the human eye it has also been reported that prostaglandins are synthesised during Cataract Surgery(12). Pros­taglandin synthetase inhibitors were found to be effective in suppressing the ocular initiative response during Cataract extraction and the post operative inflammatory reactions[7],(12)

Our study supports the above hypothesis that prostaglandins are at least partially res­ponsible for the surgically induced miosis during cataract surgery and that the miosis can be inhibited by pretreatment with Aspirin. Miosis is more after the extraction of lens which can be explained by the irritation of iris during this procedure, which gives rise to the synthesis of prostaglandins with the pretreatment with Aspirin the amount of pupillary constriction is less resulting in a free and widened accessibility to the lens per­mitting its removal easy and thus reducing the operative and post operative complica­tions.


  Summary Top


The effect of Preoperative treatment with Aspirin in comparison with a control group in preventing the surgically induced miosis during Cataract extraction studied on 72 cases is presented.

It was found that the group which received pretreatment with Aspirin showed less pupillary constriction during cataract surgery facilitating the removal of the leas and it's matter easier and also reducing the operative and post-operative complications.

 
  References Top

1.
Maurice D. M. 1954, Physiology 123: 45.  Back to cited text no. 1
    
2.
Ambache, N. 1957. Physiology 135:114.  Back to cited text no. 2
    
3.
3, Bhattacharjee P. Eakins K. E. 1912, A Invest ophthalmol visual Sc. 13: 967  Back to cited text no. 3
    
4.
Podos S. M. Becker B., 1956, Invest. Ophthalmol visual Sc, 15: 841.  Back to cited text no. 4
    
5.
Vane J. R., 1971, Nature, New biol. 231:232.  Back to cited text no. 5
    
6.
Keulen-De Vos H.C.I 1983 B. J. O. leullarce 67:94-96.  Back to cited text no. 6
    
7.
Agra S. K., (1980), Proc. All India ophthalmol Soc. p. 467  Back to cited text no. 7
    
8.
Zimmermann T. J. Gravenstin N. Sugar A. Kauf­man H. E. 1975, Ame. J. Ophthalmol 79 :817-9.   Back to cited text no. 8
    
9.
Rich W. JC. 1977, Trans. Ophthalmol U. K. 27:268.  Back to cited text no. 9
    
10.
Cole D.F and Vanger W. G. 1973, Exp. Eye. Res 17 : 357.  Back to cited text no. 10
    
11.
Newfeld A. H. Jampol L, M. Sears M.L. 1972 Nature, 238 -158.  Back to cited text no. 11
    




 

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