INTRAOCULAR AVAILABILITY AND PUPILLARY EFFECT OF FLURBIPROFEN AND INDOMETHACIN DURING CATARACT-SURGERY

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.