Efficacy and tolerance of diclofenac sodium 0.1%, flurbiprofen 0.03%, and indomethacin 1.0% in controlling postoperative inflammation.

PURPOSE: To compare the anti-inflammatory effect of diclofenac sodium 0.1% ophthalmic solution, flurbiprofen 0.03% ophthalmic solution, and indomethacin 1.0%. SETTING: Department of Ophthalmology, University of Köln, and Bundesknappschaftskrankenhaus, Sulzbach, Germany. METHODS: One hundred seventeen patients enrolled in this prospective, randomized, double-masked, and parallel-group study had phacoemulsification and intraocular lens implantation and received one of the three solutions. Preoperatively at day 1 and postoperatively at day 4 or 5 and day 12, 13, or 14, they were examined by slitlamp, applanation tonometry, and laser flare meter. RESULTS: Anterior chamber flare reduction from baseline was significantly greater in the diclofenac group than in the flurbiprofen group (P = .022). Patients in the diclofenac group had significantly less burning and stinging than those in the flurbiprofen and indomethacin groups at postoperative days 4-5 and 12-14 (P = .001). CONCLUSION: Diclofenac sodium appeared to be more potent than flurbiprofen in controlling intraocular inflammation after cataract surgery and appeared to be locally tolerated better than flurbiprofen and indomethacin.

[Corneal endothelial protection in phacoemulsification of high risk eyes with cornea guttata. Intra-individual comparison of 2 visco-elastic substances of different viscosity and molecular size]. / Hornhautendothelschutz bei Phakoemulsifikation an Risikoaugen mit Cornea guttata. Intraindividueller Vergleich zweier Viskoelastika unterschiedlicher Viskosität und Molekulargrösse.

BACKGROUND: We compared the endothelial protective function of two hyaluronic acid viscoelastics (Healon GV, Provisc) of different molecular weight and viscosity during phakoemulsification in high-risk eyes. MATERIALS AND METHODS: This prospective, randomized, single-masked clinical trial in 60 eyes was characterized by an intraindividual comparison. For better demonstration of the endothelial protective function provided by the viscoelastics, only patients with bilateral cornea guttata were included. In addition to corneal thickness, central endothelial cell counts, anterior chamber flare, visual acuity and intraocular pressure were recorded preoperatively and postoperatively on the first day and 1-2 weeks after surgery. RESULTS: No differences were observed between the endothelial cell counts in either eye. In contrast, eyes treated with Provisc had a statistically significant higher increase of corneal thickness. Transient corneal decompensation was also noticed only in three eyes of the Provisc group. CONCLUSION: The results do not support the assumption of generally better protection of the corneal endothelium by viscoelastics with lower viscosity compared to viscoelastics with higher viscosity.

[Laser flare measurement with 3 different nonsteroidal anti-inflammatory drugs after phacoemulsification with posterior chamber lens implantation]. / Laser-flare-Messung bei 3 unterschiedlichen nichtsteroidalen entzündungshemmenden Substanzen nach Phakoemulsifikation mit Hinterkammerlinsenimplantation.

In a prospective, randomised, double-masked, parallel-group study we compared the antiinflammatory effect of diclofenac sodium 0.1%, flurbiprofen 0.03%, and indomethacin 1.0% ophthalmic suspension in 99 patients undergoing phacoemulsification and posterior chamber lens implantation. The reduction in anterior chamber flare from day 1, as measured with the laser flare-meter (FM-500, KOWA) on day 4-5 postoperatively was significantly greater in the diclofenac group than with flurbiprofen (p = 0.022). Patients treated with diclofenac had significantly less burning and stinging than patients on flurbiprofen and indomethacin on postoperative days 4-5 (p < 0.0001) and 12-14 (p = 0.001). Diclofenac sodium appears to be more potent than flurbiprofen in controlling intraocular inflammation after cataract surgery, while having better local tolerance than flurbiprofen or indomethacin.