Maintaining successful mydriasis is essential during cataract extraction. The use of nonsteroidal anti-inflammatory drugs in order to inhibit trauma induced miosis has been advocated by many authors. Indomethacin 1% has proved his efficacy since many years. Flurbiprofen has been introduced more recently and has been accepted largely because of a better patient comfort. He proved his efficacy against placebo. We conducted a randomized double blind study in order to verify if there is any difference in efficacy between these two drugs. 40 cases were randomly assigned to a pretreatment, not known by the surgeons, with Indomethacin 1% (Indoptic) or Flurbiprofen 0.03% (Ocuflur). Measurements were taken at the beginning of surgery, after nucleous extraction and after irrigationaspiration of lens cortical material. Sodium hyaluronate and epinephrine were not used during this study. After nucleous extraction, the mean pupillary constriction was 1.53 mm in the Indomethacin group and 1.23 mm in the Flurbiprofen group (p greater than 0.1). After aspiration of cortical material, the mean pupillary constriction was 2.27 mm in the Indomethacin group and 2.00 in the Flurbiprofen group (p greater than 0.1). Cumulative results of patients who constricted the pupil more than 2 and 3 mm showed a better result in the Flurbiprofen group. Flurbiprofen has proved in this study his efficacy compared to an other nonsteroidal anti-inflammatory drug in inhibiting trauma induced miosis.
A progression of diabetic retinopathy (DR) has been noted following cataract surgery. The retrospective study reported here covered 219 eyes of diabetic patients on which cataract surgery was performed: in 122 cases with intracapsular cataract extraction (ICCE; Group A) without implantation of an intraocular lens (IOL), and in 97 cases with extracapsular cataract extraction and implantation of an intraocular lens (ECCE + IOL; Group B). The existence of diabetic retinopathy was established preoperatively, enabling the population to be divided into subgroups without DR (Groups A1 and B1) and with DR (Groups A2 and B2). Progression of DR was observed in 18% of the eyes in Group A, as opposed to 9.3% of those in Group B (P less than 0.05). Progression to background retinopathy was observed in 10% of the cases in Group A and in 1.3% of the cases in Group B (P less than 0.025). A deterioration was also observed in 33% of the cases in Group A2 and 40% of those in Group B2. Maculopathy progressed in 23% of the cases in Group A2 and 30% of those in Group B2. Rubeosis iridis occurred in 9% of the cases in Group A2 and 5% of those in Group B2. Vitreous hemorrhage following ICCE occurred in 12% of the cases in Group A2. As regards the incidence of neovascular glaucoma and vitreous hemorrhage, ICCE appears to carry a relatively higher risk than ECCE with IOL. This is not the cases if only the progression of maculopathy is considered.(ABSTRACT TRUNCATED AT 250 WORDS)
Several authors regard early vitrectomy as the best guarantee of success in cases of severe ocular injury. The present authors reviewed their own group of 27 patients, which included 13 cases with intraocular foreign bodies, 6 cases of blunt trauma and 8 with perforating injuries. Aside from cases which later developed retinal complications, vitrectomy was performed in 25 patients, though rarely more than a month after injury. The mean duration of postoperative follow-up was 22 months (minimum 6 month, maximum 66 months). The results and the need for silicone oil injection are discussed and compared with the literature. The timing of vitrectomy is of major importance.
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