Significantly fewer patients undergoing cataract surgery who received intracameral Omidria experienced severe pain or required intraoperative fentanyl than did patients who received epinephrine, according to a study.
“Fentanyl is a commonly employed anesthesia during cataract surgery. The ability of Omidria to reduce pain and the need for fentanyl is a welcome advance for cataract surgery patients, a population already at risk for increased exposure to and dependence on opioids,” Eric D. Donnenfeld, MD, told Healio/OSN.
In the single-masked comparative study, 41 patients were prospectively assigned to receive intracameral Omidria (phenylephrine 1% and ketorolac 0.3% intraocular solution, Omeros) and 19 patients were assigned to the epinephrine control group. Donnenfeld performed all cases, done either as femtosecond laser-assisted cataract surgery or conventional phacoemulsification under topical lidocaine gel anesthesia and intracameral preservative-free lidocaine 1%.
Mean visual analog scale (VAS) pain scores in the study group was 2.3 compared with 4.5 in the epinephrine group (P < .0001). Proportionally, 85% of patients in the study group experienced minimal VAS scores of 3 or less compared with 31.6% of patients in the study group (P < .0001).
Statistically significantly fewer patients in the study group required intraoperative fentanyl analgesia than in the control group, 9.8% vs. 42.1% (P = .006), or a 6.7 times higher chance of not needing intraoperative analgesia.
“Deaths in the U.S. from synthetic opioids, especially fentanyl, have increased more than 10-fold between 2013 and 2018 and are now involved in twice as many deaths as heroin. Reduction of opioid use in cataract surgery patients is a public health focus; many studies have shown that the use of intraoperative opioids is associated with an increased postoperative opioid requirement,” Donnenfeld said. “Our study found that Omidria reduced intraoperative pain scores in half while markedly reducing the need for fentanyl during cataract surgery.” – by Robert Linnehan
Disclosure: Donnenfeld reports he is a consultant for and holds an equity interest in Omeros Corporation.