Comparison of diclofenac sodium and flurbiprofen for inhibition of surgically induced miosis

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Purpose: To compare the efficacy of two topical nonsteroidal anti-inflammatory drugs, diclofenac sodium and flurbiprofen, commonly used prior to cataract surgery to inhibit surgically induced miosis.Setting: Department of Ophthalmology, Cornell University Medical College, The New York Hospital, New York, New York.Methods: Fifty-one patients having phacoemulsification were randomly assigned to receive topical treatment with either diclofenac sodium 0.1 % or flurbiprofen 0.03% every 15 minutes for four doses along with their dilating drops beginning 1 hour before surgery. All surgeries were videotaped, with the magnification calibrated. The videotapes were analyzed and the horizontal and vertical diameters of the pupil were measured just before the initial conjunctival incision (baseline) and then every 5 minutes during the procedure. Measurements were also made at the beginning of capsulorhexis, the beginning of phacoemulsification, the end of phacoemulsification, the end of cortical cleanup, and before and after implantation of an intraocular lens.Results: There was no statistically significant difference between the two treatment groups in baseline pupil dilation; however, regardless of the drug received, the light irides were, on average, more dilated at baseline than the dark ones. After surgery began, there were no statistically significant differences between the two groups at any time or surgical interval except at the start of phacoemulsification, at which point the flurbiprofen-treated eyes were more dilated than the diclofenac-treated eyes.Conclusion: Diclofenac sodium and flurbiprofen were equally effective in maintaining intraoperative mydriasis during cataract surgery.