[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.211.41.181. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
July 1994

Nonsteroidal Anti-inflammatory Drugs and Cataract Surgery

Author Affiliations

Chicago, Ill; San Diego, Calif

Arch Ophthalmol. 1994;112(7):891-894. doi:10.1001/archopht.1994.01090190039018

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

Abstract

Prostaglandins ARE 20-carbon metabolites of arachidonic acid that are biosynthesized by ocular tissues and are involved in human intraocular inflammation.1 They are released in response to ocular trauma, including surgery.2 When released in large concentrations following trauma, intraocular surgery, or in association with uveitis, they may contribute to the disruption of the blood-aqueous barrier, miosis, and cystoid macular edema (CME). By inhibiting the cyclooxygenase pathway of prostaglandin biosynthesis, a major metabolic pathway of arachidonic acid, nonsteroidal antiinflammatory drugs (NSAIDs) may be useful in patients undergoing cataract surgery.3 Inhibitors of the lipoxygenase pathway, another major pathway of arachidonic acid metabolism, also are being evaluated.

The US Food and Drug Administration (FDA) has approved several topical NSAIDs, each primarily a cyclooxygenase inhibitor, for clinical use in ophthalmology, but these approvals have been limited solely to specific indications. For example, flurbiprofen sodium (Ocufen) and suprofen (Profenal) are only approved for

References
1.
Bito LZ, Stjernschantz J, eds. The Ocular Effects of Prostaglandins and Other Eicosanoids . New York, NY: Alan R Liss Inc; 1989.
2.
Sears ML.  Aphakaic cystoid macular edema: the pharmacology of ocular trauma . Surv Ophthalmol . 1984;28( (suppl) ):525-534.Article
3.
Flach AJ:  Cyclo-oxygenase inhibitors in ophthalmology . Surv Ophthalmol . 1992;36:259-284.Article
4.
Yannuzzi LA, Landau AN, Turtz AL.  Incidence of aphakic cystoid macular edema with the use of topical indomethacin . Ophthalmology . 1981;88:947-954.Article
5.
Jampol LM.  Pharmacologic therapy of aphakic cystoid macular edema: a review . Ophthalmology . 1982;89:891-897.Article
6.
Jampol LM, Sander DR, Kraff MC.  Prophylaxis and therapy of aphakic cystoid macular edema . Surv Ophthalmol . 1984;28( (suppl) ):535-539.Article
7.
Jampol LM.  Pharmacologic therapy of aphakic and pseudophakic cystoid macular edema: 1985 update . Ophthalmology . 1985;103:1134-1135.
8.
Jampol LM.  Aphakic cystoid macular edema: a hypothesis . Arch Ophthalmol . 1985;103:1134-1135.Article
9.
Keates RH, McGowan KA.  Clinical trial of flurbiprofen to maintain pupillary dilation during cataract surgery . Ann Ophthalmol . 1984;16:919-921.
10.
Summary Basis of Approval of Ocufen® (Allergan's Flurbiprofen) . Washington, DC: US Dept of Health and Human Services, Food and Drug Administration; 1987.
11.
Summary Basis of Approval for Profenal® (Alcon's Suprofen) . Washington, DC: US Dept of Health and Human Services, Food and Drug Administration; 1989.
12.
Gimbel HV.  The effect of treatment with topical nonsteroidal anti-inflammatory drugs with and without intraoperative epinephrine on the maintenance of pupillary mydriasis during cataract surgery . Ophthalmology . 1989;96:585-588.Article
13.
Bito LZ.  Surgical miosis: have we been misled by a bunch of rabbits? Ophthalmology . 1990;97:1-2.Article
14.
Camras CB, Miranda OC.  The putative role of prostaglandins in surgical miosis . In: Bito LZ, Stjernschantz J, eds. The Ocular Effects of Prostaglandins and Other Eicosanoids . New York, NY: Alan R Liss Inc; 1989:197-210.
15.
Eakins KE.  Prostaglandin and non-prostaglandin mediated breakdown of the blood-aqueous barrier . Exp Eye Res . 1977;80( (suppl) ):483-498.Article
16.
Diestelhorst M, Aspacher F, Konen W, Krieglstein GK.  The effect of flurbiprofen 0.03% eye drops on the blood aqueous barrier in extracapsular cataract extraction with IOL implantation . Int Ophthalmol . 1991;15:69-73.Article
17.
Flach AJ, Graham J, Kruger L, Stegman RC, Tanenbaum L.  Quantitative assessment of postsurgical breakdown of the blood aqueous barrier following administration of ketorolac tromethamine solution: a double-masked, paired comparison with vehicle-placebo solution study . Arch Ophthalmol . 1988;106:344-347.Article
18.
Vickers FF, McGuigan LJB, Ford C, et al.  The effect of diclofenac sodium ophthalmic on the treatment of postoperative inflammation . Invest Ophthalmol Vis Sci . 1991;32( (suppl) ):793.
19.
Flach AJ, Jaffe NS, Akers WA, et al.  The effect of ketorolac 0.5% solution in reducing postoperative inflammation: double mask parallel comparison with dexamethasone phosphate 0.1% solution . Ann Ophthalmol . 1989;21:407-411.
20.
Kraff MC, Sanders DR, McGuigan L, Raanan MG.  Inhibition of blood-aqueous humor barrier breakdown with diclofenac: a fluorophotometric study . Arch Ophthalmol . 1990;108:380-383.Article
21.
Gass JDM, Norton EWD.  Follow-up study for cystoid macular edema following cataract extraction . Trans Am Acad Ophthalmol Otolaryngol . 1969;73:665-682.
22.
Stern AL, Taylor DM, Dalburg LA, Cosentino RT.  Pseudophakic cystoid maculopathy: a study of 50 cases . Ophthalmology . 1981;88:942-946.Article
23.
Melberg NS, Olk RJ.  Corticosteroid-induced ocular hypertension in the treatment of aphakic or pseudophakic cystoid macular edema . Ophthalmology . 1993;100:164-167.Article
24.
Flach AJ, Dolan BJ, Irvine AR.  Effectiveness of ketorolac 0.5% solution for chronic aphakic and pseudophakic cystoid macular edema . Am J Ophthalmol . 1987;103:479-486.
25.
Flach AJ, Jampol LM, Yannuzzi LA, et al.  Improvement in visual acuity in chronic aphakic and pseudophakic cystoid macular edema after treatment with topical 0.5 ketorolac tromethamine . Am J Ophthalmol . 1991;112:514-519.
26.
Trousdale MD, Barlow WE, McGuigan LJ.  Assessment of diclofenac on herpes keratitis in rabbit eyes . Arch Ophthalmol . 1989;107:1664-1666.Article
27.
Eiferman RA, Hoffman RS, Sher NA.  Topical diclofenac reduces pain following photorefractive keratectomy . Arch Ophthalmol . 1993;111:1022.Article
×