Topical flurbiprofen and diclofenac suppress blood-aqueous barrier breakdown in cataract surgery: a fluorophotometric study.

A total of 33 eyes which underwent intracapsular extraction of senile cataract were divided into three groups, 1) 13 eyes operated on with routine medication alone, 2) 10 eyes operated on with additional topical flurbiprofen and 3) 10 eyes operated on with additional topical diclofenac. In the latter two groups, in addition to routine medication, an ophthalmic solution of 0.1% flurbiprofen or diclofenac was instilled 3, 2, 1 and 0.5 hours prior to surgery and postoperatively 4 times a day for 6 days. On the 6th postoperative day, fluorophotometric examination with oral fluorescein administration was carried out in all eyes to determine the apparent transfer coefficient of the dye into the anterior chamber (k'in) and out of the anterior chamber (k'out). After oral administration of a 10% fluorescein solution at a dose of 5 mg per kg of body weight, the time-courses of the apparent fluorescein concentrations in the anterior chamber and in the whole plasma were determined for 7-8 hours. The apparent transfer coefficient was calculated from the time-courses by computer fitting of Davson's equation. The value of k'in represents the permeability of the blood-aqueous barrier and it averaged 0.039 +/- 0.021 hour-1 (Mean +/- SD) in the routine medication group, 0.014 +/- 0.007 hour-1 in the flurbiprofen group, and 0.017 +/- 0.008 hour-1 in the diclofenac group. The values in the latter two groups were significantly smaller than that in the routine medication group (Mann-Whitney U-test, P less than 0.005). It was concluded that topical flurbiprofen or diclofenac suppressed the disruption of the blood-aqueous barrier that had occurred during cataract surgery.