343 Comparison of the anti- inflammatory effects of diclofenac and flurbiprofen eye drops after cataract extraction I. Koc ¸ak, I. Sagdic Yalvac ¸, A. Koc ¸ak, A. Nuro ¨zler, N. U ¨ nlu ¨, R. Kasim and S. Duman Department of Ophthalmology, Ankara Hospital, Ankara, Turkey ABSTRACT. Purpose: A clinical double-blind study was performed in patients who had undergone extracapsular cataract extraction and intraocular lens implantation (ECCEπIOL) to compare the anti-inflammatory effects of diclofenac sodium 0.1% and flurbiprofen 0.03% eye drops. Methods: The diclofenac group included 21 eyes of 21 patients and the flurbi- profen group included 22 eyes of 22 patients. The parameters compared were pachymetry of the cornea, corneal surface changes, intraocular pressure (IOP) and the degree of inflammation of the anterior chamber at one, three and six weeks after cataract surgery. Results: There was no statistically significant difference between the two treat- ment groups in corneal pachymetry, corneal surface changes, IOP and the an- terior chamber inflammation (p±0.05). Conclusion: Both drugs were well tolerated and may be safely used to reduce inflammation for cataract surgery. Key words: diclofenac sodium – flurbiprofen – cataract surgery – ocular inflammation. Acta Ophthalmol. Scand. 1998: 76: 343–345 Copyright c Acta Ophthalmol Scand 1998. ISSN 1395-3907 A number of topical non-steroidal anti- inflammatory drugs (NSAIDs) have been evaluated as alternatives to the use of topical steroids in treating post-sur- gical ocular inflammation. Such agents may effectively reduce clinical inflam- mation while avoiding some of the adverse side effects generally associated with top- ical corticosteroids such as glaucoma, in- hibition of wound healing or facilitation of herpetic infection (Sanders & Kraff, 1984). Diclofenac sodium and flurbiprofen are non-steroidal anti-inflammatory drugs and both substances have been Presented partly at the XIII th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), Amsterdam Holland, Oc- tober 1995. used in the treatment of anterior segment eye inflammation and as prophylaxis against cystoid macular edema (Struck et al. 1993; Killer et al. 1993). In this prospective double blind study, we compared the efficiency, safety and lo- cal tolerance of diclofenac sodium and flurbiprofen eye drops in the postopera- tive treatment of patients undergoing extracapsular cataract extraction with lens implantation (ECCEπIOL). Material and Methods Patients requiring ECCEπIOL implan- tation with no peroperative compli- cations were enrolled in this randomized, double-masked comparative study. Pa- tients were excluded from the study if they had a history of systemic or ocular inflammation, if they were taking oral or ophthalmic steroids or NSAIDs or if they had significant ocular disease other than cataract. Patients were assigned randomly to re- ceive 0.03% flurbiprofen ophthalmic solu- tion (preserved with thiomersal 0.005%, Ocufen A ) or 0.1% diclofenac sodium (preserved with thiomersal 0.004%, Vol- taren Ophtha A ) into the eye before surgery. Twenty-one eyes of 21 patients received diclofenac sodium (diclofenac group) and 22 eyes of 22 patients received flurbiprofen (flurbiprofen group). All pa- tients were operated on one eye only by standardized ECCEπIOL. Topical anti- inflammatory medications were given every 6 hours in 3 doses beginning at 6 p.m. on the evening prior to surgery. On the day of surgery one drop of these solu- tions was administered at 90, 60, 30 and 15 minutes before the surgery. The eyes of all patients were dilated with 1% tropicamide, and 10% phenylephrine. The patients received their respective medications four times daily for three to six weeks after cataract surgery. Both groups received additional drops of tob- ramycin 0.3% four times daily for one week. No steroids were administered postoperatively. All patients were examined one, three and six weeks postoperatively and the fol- lowing parameters were assessed; con- junctival hyperemia, corneal thickness, corneal surface changes, IOP and in- flammation of the anterior chamber. Conjunctival hyperemia and corneal punctuation were rated as 0: no sign of intolerance, 1: mild, 2: moderate, 3: se- vere. Anterior chamber cells were