Miotics after modern cataract surgery are history

Research output: Contribution to journalArticleResearchpeer-review


PURPOSE: The aim of this study was to investigate the usefulness of a long-acting miotic (physostigmine) after phacoemulsification in preventing peripheral anterior synechiae (PAS), lens dislocation, and high postoperative intraocular pressure.

METHODS: This was a prospective randomized controlled trial of 400 patients (400 eyes) scheduled for phacoemulsification. Patients were randomly assigned either to receive a single application of physostigmine ointment directly after phacoemulsification or not. The main outcome measures were the change of intraocular pressure (IOP) before and after surgery, number of extra outpatient clinic visits within 4 weeks postoperatively, verbal rating pain scale (VRS), status of the angle by gonioscopy, and best corrected visual acuity (BCVA).

RESULTS: There was no significant difference in IOP and BCVA between both groups. There were more patients who reported a VRS score of more than 3 in the physostigmine group (P=0.021). PAS or (anterior) lens dislocation was not observed.

CONCLUSION: In eyes without co-morbidity, the routine use of physostigmine ointment has lost its rationale.

Original languageEnglish
Pages (from-to)98-101
Number of pages4
JournalJournal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics
Issue number2
Publication statusPublished - Apr 2012


  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gonioscopy
  • Humans
  • Intraocular Pressure/drug effects
  • Lens Subluxation/etiology
  • Male
  • Middle Aged
  • Miotics/administration & dosage
  • Ocular Hypertension/etiology
  • Ointments
  • Pain Measurement
  • Phacoemulsification/adverse effects
  • Physostigmine/administration & dosage
  • Prospective Studies
  • Tissue Adhesions/etiology
  • Treatment Outcome
  • Visual Acuity/drug effects


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