COMPARISON OF DICLOFENAC SODIUM AND FLURBIPROFEN FOR INHIBITION OF SURGICALLY INDUCED MIOSIS

Purpose: To compare the efficacy of two topical nonsteroidal anti-infl ammatory drugs, diclofenac sodium and flurbiprofen, commonly used prio r to cataract surgery to inhibit surgically induced miosis. Setting: D epartment of Ophthalmology, Cornell University Medical College, The Ne w York Hospital, New York, New York. Methods: Fifty-one patients havin g phacoemulsification were randomly assigned to receive topical treatm ent with either diclofenac sodium 0.1% or flurbiprofen 0.03% every 15 minutes for four doses along with their dilating drops beginning 1 hou r before surgery. All surgeries were videotaped, with the magnificatio n calibrated. The videotapes were analyzed and the horizontal and vert ical diameters of the pupil were measured just before the initial conj unctival incision (baseline) and then every 5 minutes during the proce dure. Measurements were also made at the beginning of capsulorhexis, t he beginning of phacoemulsification, the end of phacoemulsification, t he end of cortical cleanup, and before and after implantation of an in traocular lens. Results: There was no statistically significant differ ence between the two treatment groups in baseline pupil dilation; howe ver, regardless of the drug received, the light irides were, on averag e, more dilated at baseline than the dark ones. After surgery began, t here were no statistically significant differences between the two gro ups at any time or surgical interval except at the start of phacoemuls ification, at which point the flurbiprofen-treated eyes were more dila ted than the diclofenac-treated eyes. Conclusion: Diclofenac sodium an d flurbiprofen were equally effective in maintaining intraoperative my driasis during cataract surgery.