MKO Melt Is Effective for Cataract Surgery Conscious Sedation

Sublingual midazolam, ketamine HCl, and ondansetron (MKO) melt has been found to be a safe and effective opioid-sparing conscious sedation alternative for cataract surgery, according to a prospective controlled analysis involving 610 individuals. The results were presented during the American Academy of Ophthalmology’s 2018 annual meeting in Chicago in a poster presented by Maggie Jeffries, MD, an anesthesiologist specializing in ophthalmology at the Eye Center of Texas in Houston.

Participants, who averaged ~66 years of age, were randomly assigned to receive diazepam; diazepam/tramadol/ondansetron; or MKO during either conventional or femtosecond or laser cataract surgery. Investigators compared surgical and discharge times, IV medications given, and satisfaction among surgeons and patients. Among the results:  

• Overall, additional IV meds were needed for ~one-third of patients, including 38% of individuals who received diazepam, 32% diazepam/tramadol/ondansetron, and 27% MKO.
• Anxiety was the most cited reason (23%, 19%, and 15%, respectively).
• The lower incidence of anxiety and need for additional IV meds in patients receiving MKO was statistically significant.
• Surgical and discharge times were similar in all groups, as was surgeon and patient satisfaction.
• No differences were seen between traditional and femtosecond procedures.

Jeffries M, Wade E, Mayo M, Eisele V, Janecki J. Conscious sedation efficacy of the novel medication, MKO melt (midazolam, ketamine, ondansetron), during cataract surgery. Poster presented at: AAO 2018 annual meeting; October, 26-30, 2018; Chicago.