Prophylaxis of aphakic cystoid macular edema using topical indomethacin.

The purpose of the present investigation was to define clinically the effect of topical indomethacin in preventing CME. The study was conducted on 50 patients who underwent bilateral intracapsular extraction of senile cataracts. One eye was used as the experimental subject and the other as the control. Postoperative alterations in the permeability of the blood-aqueous barrier and the chronological relationship of the changes in the retina and the blood-aqueous barrier were also studied. The mechanism underlying these postoperative ocular changes is discussed. In cases treated with indomethacin, the incidence and severity of CME were much milder than in the untreated fellow eye. These results were satistically significant. The chronological relationship between the hypothesized disruption of the blood-aqueous barrier and occurrence of CME after surgery strongly suggests that the latter occurs secondary to the former which, in turn, is initiated by prostaglandins synthesized in the iris during (and probably shortly after) the lens extraction. Thus prostaglandins may serve as a trigger in the production of the disorder, though this is not universally accepted.