Inhibition of Intraoperative Miosis
In ophthalmology, topical flurbiprofen sodium is used prophylactically before ocular surgery (e.g., cataract extraction) to prevent or reduce intraoperative miosis. Intraoperative miosis may decrease direct visualization of intraocular structures and increase the difficulty of the operative procedure (e.g., aspiration of lens material during cataract surgery and implantation of an intraocular lens).
There currently is limited information available on the clinical use of topical flurbiprofen for the inhibition of intraoperative miosis. Results to date indicate that the drug can effectively reduce miosis occurring during cataract extraction. Flurbiprofen has been used topically in conjunction with phenylephrine, gentamicin, and tropicamide prior to cataract surgery. Further clinical evaluation is needed.
Results of some studies indicate that use of a 0.1% topical solution of flurbiprofen sodium (not commercially available) before and after cataract surgery may prevent or reduce disruption of the blood-aqueous humor barrier that occurs during the surgery.
The value of topical flurbiprofen for the prevention and management of postoperative ocular inflammation remains to be more fully determined. Limited data suggest that use of topical flurbiprofen before and after argon laser trabeculoplasty in patients with open-angle glaucoma may decrease the degree of conjunctival erythema present 24 hours after the procedure and the occurrence and degree of post-procedural conjunctival injection; however, the drug appears to have little or no effect on intraocular inflammation (anterior chamber cells or flare) or on the transient increase in IOP that occurs following the laser treatment. Based on limited data, use of topical flurbiprofen before and after cyclocryotherapy in patients with refractory glaucoma also appears to have little or no effect on postoperative intraocular inflammation. Further evaluation of the effects of topical flurbiprofen on intraocular inflammation is needed.
The value of topical NSAIAs, including flurbiprofen, for the prevention of postoperative cystoid macular edema in patients undergoing cataract surgery remains to be determined.
In animals, topical flurbiprofen has inhibited corneal neovascularization induced by chemical or thermal burns or prolonged use of contact lenses. Controlled studies are needed to determine the value, if any, of topical NSAIAs in the inhibition of neovascularization in human corneal injuries.
For systemic uses of flurbiprofen, see 28:08.04.92.