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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
Jampol LM, Jain S, Pudzisz B, Weinreb RN. Nonsteroidal Anti-inflammatory Drugs and Cataract Surgery. Arch Ophthalmol. 1994;112(7):891-894. doi:10.1001/archopht.1994.01090190039018