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Comparisons were made against placebo\/vehicle, phenylephrine alone, and epinephrine.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A comprehensive search of PubMed, Cochrane CENTRAL, Embase, Scopus, and Web of Science was conducted. Eligible studies were randomized clinical trials and observational studies assessing intracameral phenylephrine\/ketorolac against control groups. Key outcomes included pain management, pupil diameter, and adverse events. Data were synthesized using meta-analysis with fixed and random-effects models, and heterogeneity was assessed using the I<jats:sup>2<\/jats:sup> statistic.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Ten studies, including 220,061 patients, were analyzed. The combination of phenylephrine\/ketorolac significantly reduced postoperative pain (RR\u2009=\u20090.72, 95% CI: 0.60\u20130.86) and opioid use (RR\u2009=\u20090.45, 95% CI: 0.23\u20130.89) compared to vehicle and epinephrine. PE\/K also maintained a larger pupil diameter (MD\u2009=\u20090.54 mm, 95% CI: 0.32\u20130.75) with minimal heterogeneity (I<jats:sup>2<\/jats:sup>\u2009=\u20090%) and reduced the incidence of severe pain (RR\u2009=\u20090.41, 95% CI: 0.27\u20130.63). No significant differences in adverse events such as elevated intraocular pressure, inflammation, or headaches were observed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Phenylephrine\/ketorolac (OMIDRIA\u00ae) demonstrates superior efficacy in maintaining intraoperative mydriasis, reducing postoperative pain, and minimizing opioid use without increasing adverse events. This combination offers a preferable alternative to traditional agents, potentially setting a new standard for pain management and pupil dilation in cataract surgery.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00417-025-06811-y","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T09:04:27Z","timestamp":1743411867000},"page":"2265-2275","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimizing pain management and pupil dilation in cataract surgery: a systematic review and meta-analysis of phenylephrine\/ketorolac (OMIDRIA\u00ae)"],"prefix":"10.1007","volume":"263","author":[{"given":"Mohamed Abo","family":"Zeid","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr","family":"Elrosasy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kareem","family":"Khalefa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Elhadary","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shrouk F.","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr","family":"Elkelany","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-2188","authenticated-orcid":false,"given":"Hashem Abu","family":"Serhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,29]]},"reference":[{"key":"6811_CR1","doi-asserted-by":"crossref","unstructured":"Hashemi H, Pakzad R, Yekta A, Aghamirsalim M, Pakbin M, Ramin S et al (2020) Global and regional prevalence of age-related cataract: a comprehensive systematic review and meta-analysis. 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