Recent clinical studies indicate that
flurbiprofen, a
cyclooxygenase inhibitor, prevents
miosis and breakdown of the blood-aqueous barrier during
cataract surgery. Yet based on clinical and experimental data, some researchers do not agree that
flurbiprofen prevents
miosis. We conducted a double-blind clinical study of the effects of topical 0.03%
flurbiprofen sodium on intraoperative pupillary diameter and iris
fluorescein leakage after extracapsular
cataract surgery. In the first phase of the study, 120 patients who had extracapsular
cataract extraction with posterior chamber
intraocular lens implantation were randomly assigned to receive preoperative topical
flurbiprofen or a placebo, with or without intraoperative
epinephrine, in addition to the standard regimen. In the second phase, 60 of the 120 patients continued the topical
flurbiprofen or placebo for one month postoperatively. Iris
fluorescein angiography was performed at the end of the first and the fourth weeks. The results indicate that
flurbiprofen was significantly more effective (P < .0001) in maintaining
mydriasis during surgery than the placebo. This action was enhanced by intraoperative
epinephrine.
Flurbiprofen also significantly reduced (P < .001) postoperative iris
fluorescein leakage.