Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surgically induced miosis (SIM) frequently occurs during extracapsular cataract extraction (ECCE). A randomized clinical trial was performed to evaluate the effect of 3 nonsteroidal antiinflammatory drugs Indomethacin 1%, Diclofenac 0.1% and Flurbiprofen 0.03%, administered topically before ECCE, on the maintenance of mydriasis during surgery. The patients were grouped based on the type of NSAID given preoperatively in addition to the standard mydriatic agents: 46 patients in group A (Indomethacin), 40 patients in B (Diclofenac), 44 patients in C (Flurbiprofen) and 34 patients formed control group D (no NSAID was instilled). Horizontal pupillary diameter measurements were taken, using a caliper, immediately prior to surgery (step 0), after capsulotomy (step I), after expression of the lens nucleus (step II) and after irrigation-aspiration of the cortical remnants (step III). Differences in pupillary diameter between step 0 and the different surgical steps were used as indices of pupillary constrictions observed in the 4 groups. A significantly less pupillary constriction was found in groups A and C than in D between steps 0 and II (p = 0.01) and in groups A and C than in B and D between steps 0 and III (p = 0.001). Our results show that Indomethacin 1% and Flurbiprofen 0.03%, compared to Diclofenac 0.1% and no NSAID regime, are significantly more effective in maintaining mydriasis during cataract surgery.
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PMID:The effect of indomethacin, diclofenac and flurbiprofen on the maintenance of mydriasis during extracapsular cataract extraction. 148 71

Diclofenac is superior to other nonsteroid anti-inflammatory drugs (NAD) with respect to its antiphlogistic properties, as demonstrated in laboratory animal experiments. The antiphlogistic action of diclofenac eyedrops versus placebo eyedrops in the prophylaxis of cystoid macular edema (CME) and postoperative inflammatory symptoms was therefore tested in a prospective randomized double-blind study. A total of 179 patients with intracapsular cataract operations and Choyce Mark IX anterior chamber lens implantation received 2 drops 5 times preoperatively and 1 drop 5 times postoperatively until they were discharged, and then subsequently for 6 months they used 1 drop of diclofenac or placebo eyedrops 3 times. To evaluate the CME, fluorescence angiography was carried out on all patients on the day of discharge, 6 weeks later, and after 6 months following the operation. The patients who completed the study according to plan numbered 112. With diclofenac eyedrops, significantly less CME occurred in comparison with treatment with placebo eyedrops (p = 0.03). Visual acuity improved faster and the postoperative inflammatory symptoms receded more quickly in the diclofenac group.
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PMID:[Prevention of cystoid macular edema with diclofenac eyedrops in intracapsular cataract extraction using the Choyce Mark IX anterior chamber lens]. 269 10

A controlled trial of diclofenac sodium was carried out in 100 patients undergoing intracapsular cataract extraction. All patients were treated with dexamethasone eyedrops twice daily, plus either diclofenac sodium 50 mg tid or matching placebo tid, started 24 hours before surgery and continued for four weeks. In comparison with those in the placebo group, patients in the diclofenac group showed significant decreases in most signs of ocular inflammation. Diclofenac therapy was well tolerated, except in one patient, and may safely be used to reduce intraocular inflammation.
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PMID:Treatment of ocular inflammation with diclofenac sodium: double-blind trial following cataract surgery. 390 70

A clinical double-blind study of patients who had undergone intracapsular cataract extraction with intraocular implant was performed in an attempt to compare the anti-inflammatory effect of Dexamethasone and Diclofenac eye drops. The parameters compared were: degree of inflammation of the anterior chamber; pachymetry of the cornea; objective and subjective tolerance of the eye drops; examination of the fundus (fluorescein angiography on the 60th day); intraocular pressure. The statistical analysis of the different parameters shows a tendency in favor of the non-steroidal agent for intraocular pressure; there was no apparent difference in the anti-inflammatory actions of the two substances.
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PMID:[Comparison of the anti-inflammatory effect of collyria of dexamethasone and diclofenac]. 637 74

Two hundred consecutive patients were enrolled in a randomized, prospective clinical trial evaluating the efficacy of diclofenac sodium (Voltaren Ophthalmic) in reducing patient discomfort after cataract surgery. Other factors evaluated were the effect of preoperative flurbiprofen (Ocufen) in preventing intraoperative miosis and on postoperative discomfort and the effect of incision size and intraocular carbachol (Miostat) on postoperative comfort. Diclofenac significantly reduced discomfort during the first 24 hours after surgery but not two to three days postoperatively, although there was a trend toward reduction. Flurbiprofen given preoperatively did not affect postoperative discomfort. It also did not affect pupil size at the start of surgery but did reduce intraoperative miosis. Incision size (5.2 mm versus 7.0 mm) had no effect on discomfort. Miostat did not affect discomfort, although there was a trend toward more discomfort. The results indicate that topical diclofenac, given immediately after cataract surgery, significantly reduces discomfort during the first 24 postoperative hours.
J Cataract Refract Surg 1995 Mar
PMID:Efficacy of diclofenac sodium solution in reducing discomfort after cataract surgery. 779 Oct 60

Nonsteroidal anti-inflammatory drugs (NSAIDs) produce potent analgesic, antipyretic, and anti-inflammatory effects. We studied postoperative pain in 97 consecutive patients having photorefractive keratectomy (PRK) by an excimer laser with different topical NSAID protocols. Treatment with topical homatropine hydrobromide, either diclofenac sodium (Voltaren Ophthalmic) or ketorolac tromethamine (Acular), and a soft contact lens was most effective in achieving post-PRK analgesia. We also studied post-PRK myopic regression in 68 consecutive patients and found that flurbiprofen sodium (Ocufen), when added to topical steroid protocols, significantly reduced myopic regression for one year postoperatively more than steroids alone or steroids and diclofenac sodium. Diclofenac, used with topical steroids, had less of an additive effect on myopic regression than did flurbiprofen. Topical NSAIDs are useful adjuncts to PRK therapy, both to eliminate postoperative pain and to control post-PRK myopic regression.
J Cataract Refract Surg 1994 Mar
PMID:Use of topical nonsteroidal anti-inflammatory drugs in excimer laser photorefractive keratectomy. 800 90

We evaluate prospectively the effects of traditional herbal medicines on elevation of aqueous flare after complicated cataract surgery. Twenty-seven patients with bilateral complicated cataract undergoing phacoemulsification with intraocular lens implantation were studied. The patients received no herbal medicine when the right eyes underwent cataract surgery. Fifteen patients were given kakkon-to (ge-gen-yang in Chinese) granules (7.5 g daily) and 12 patients were given sairei-to (cai-ling-tang in Chinese) granules (9.0 g daily), for 3 days before surgery, the day of surgery, and for 7 days after surgery when the left eyes underwent cataract surgery. Diclofenac eyedrops were instilled in all patients. Aqueous flare was measured before and after surgery. The differences in preoperative flare intensities between groups treated with Kakkon-to and Sairei-to were not significant. In the untreated right eyes of the kakkon-to and Sairei-to groups, the flare was 99.1 and 89.6 photon counts/msec, respectively, on day 1, and then gradually decreased. The flare intensities on days 1, 3, and 5 in the kakkon-to treated left eyes were significantly lower than in those of the untreated right eyes (Fig. 1). The flare intensities in the Sairei-to treated left eyes were the same as those in the untreated right eyes. Kakkon-to contributed to a reduction of aqueous flare elevation after surgery for complicated cataract.
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PMID:Effects of kakkon-to and sairei-to on aqueous flare elevation after complicated cataract surgery. 1223 23

Various aqueous and oily diclofenac ophthalmic formulations were subjected to accelerated and long term stability studies. Degradation of diclofenac was found to follow first-order kinetics. Among the aqueous formulations containing preservative, formulation with PMA, PMN, SA, MP/PP and SMS showed diclofenac content above 90% after 6 months of accelerated and 12 months of room temperature storage. Diclofenac 0.1%, w/v aqueous formulation (pH 7.4), with 5-10% overages, containing SMS, MP/PP or PMN look promising taking both stability and corneal permeability in view. However, for use in cataract surgery formulation without preservative appears ideal. Oily ophthalmic formulations except those in olive and mustard oil, had more than 90% drug content after 6 months of accelerated and 12 months of room temperature storage. Diclofenac (0.2%, w/v) ophthalmic solution in sesame oil with 3% overage and containing benzyl alcohol (0.5%, v/v) as preservative, appears ideal, taking both stability and corneal permeability in view.
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PMID:Stability studies on aqueous and oily ophthalmic solutions of diclofenac. 1933 4

Prostaglandins have been shown to mediate various manifestations of ocular inflammation. Diclofenac and indomethacin are thought to inhibit cyclooxygenase, an enzyme necessary for prostaglandin biosynthesis. The anti-inflammatory effect and subjective tolerance of topical diclofenac 0.1% and indomethacin 0.1% were examined in the postoperative treatment of 64 patients undergoing extracapsular cataract surgery with IOL implantation in a prospective, comparative, single masked study. Patients with preexisting ocular disease or whose intraoperative course was complicated were excluded from the study. Ophthalmologic examinations were performed preoperatively and at days: 1, 4-6, and 28-30 post surgery. Tolerance was assessed by subjective patient evaluation. There was no significant difference (p < 0.05) in postoperative inflammation among the two treatment groups. There was a trend for more severe corneal edema on day 4-6 in the indomethacin group. Diclofenac was slightly better tolerated.
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PMID:Comparison of the anti-inflammatory potency and local tolerance of diclofenac and indomethacin eye drops in the postoperative management of patients undergoing ECCE with PCL. 2282 75

Diclofenac instillation has been used widely in cataract surgery to prevent postoperative inflammation. Since diclofenac binds strongly to albumin in the circulation, it does not have a sufficient effect on patients in whom diclofenac binds strongly to albumin in the aqueous humor. A decrease in diclofenac binding and an increase in free diclofenac levels are necessary in these patients. The binding of diclofenac to albumin was investigated in the aqueous humor. In a diclofenac binding assay with albumin in the aqueous humor of individual patients, diclofenac was extracted from aliquots of the aqueous humor, and its total levels were measured using ultra high performance liquid chromatography (UHPLC). Free diclofenac levels were measured using ultrafiltration and UHPLC. The albumin-binding fraction of diclofenac was 0.8 or higher in the aqueous humor of some patients. Ibuprofen significantly inhibited diclofenac binding to site II of albumin in mimic aqueous humor, but not in pooled aqueous humor. This difference may have been due to the weak binding of diclofenac to site II in the pooled aqueous humor. Flurbiprofen was used instead of diclofenac. Flurbiprofen has been shown to bind more strongly than diclofenac to the same site of albumin. Thus, the inhibitory effect of ibuprofen on the binding of flurbiprofen to albumin was investigated in pooled aqueous humor. The results indicated that ibuprofen significantly inhibited the flurbiprofen binding. An effective diclofenac administration method may be established for clinical application by the instillation of an appropriate inhibitor of binding to the albumin site II.
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PMID:Albumin-binding of diclofenac and the effect of a site II inhibitor in the aqueous humor of cataract patients with the instillation of diclofenac. 2439 76


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