H. Gimbel et al., INTRAOCULAR AVAILABILITY AND PUPILLARY EFFECT OF FLURBIPROFEN AND INDOMETHACIN DURING CATARACT-SURGERY, Journal of cataract and refractive surgery, 22(4), 1996, pp. 474-479
Purpose: To compare the bioavailability and pupillary effect of flurbi
profen and indomethacin during phacoemulsification and intraocular len
s implantation. Setting: Gimbel Eye Centre, Calgary, Alberta, Canada.
Methods: In this prospective, randomized, double-masked study, 236 pat
ients had cataract extraction by phacoemulsification and posterior cha
mber intraocular lens implantation. They received topical flurbiprofen
0.03% solution or indomethacin 1% suspension applied every 15 minutes
for 60 to 75 minutes before surgery, An aqueous humor sample (100 mu
L) was taken immediately before the corneal incision was made. Pupil d
iameters (horizontal and vertical) were measured before aqueous humor
sampling, after phacoemulsification, after irrigation and aspiration (
I/A), and after acetylcholine instillation. Results: Mean concentratio
n of flurbiprofen and indomethacin in the aqueous humor was 59.8 ng/mL
and 90.2 ng/ml, respectively (P < .001). The percentage of dose detec
ted in the aqueous humor was 4.38% in the flurbiprofen group and 0.21%
in the indomethacin group (P < .001), Pupil diameters were 7.2 and 7.
3 mm presurgery and 7.0 and 7.0 mm after I/A in the flurbiprofen and i
ndomethacin groups, respectively (P > .05), No adverse events were rep
orted in either group.Conclusions: Although the absolute concentration
of indomethacin was higher, the percentage of dose detected in the aq
ueous humor was 20 times greater in the flurbiprofen than in the indom
ethacin group, Flurbiprofen is absorbed 20 times more readily than ind
omethacin, Both drugs were equally effective in preventing miosis duri
ng cataract surgery.