Clinical Study The Effect of NSAID Pretreatment on Aqueous Humor Prostaglandin E 2 Concentration in Eyes Undergoing Femtosecond Laser-Assisted Capsulotomy Vasilios F. Diakonis , 1,3 Apostolos G. Anagnostopoulos , 1 Angeliki Moutsiopoulou, 2 Nilufer Yesilirmak, 1 Florence Cabot, 1 Daniel P. Waren, 1 Terrence P. O’Brien, 1 Sonia H. Yoo , 1 Robert J. Weinstock, 3 and Kendall E. Donaldson 1 1 Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA 2 Department of Chemistry, University of Miami, Miami, FL, USA 3 e Eye Institute of West Florida, Largo, FL, USA Correspondence should be addressed to Vasilios F. Diakonis; diakonis@gmail.com Received 11 September 2017; Accepted 24 June 2018; Published 10 July 2018 Academic Editor: Lisa Toto Copyright © 2018 Vasilios F. Diakonis et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To assess aqueous humor concentration of prostaglandin E 2 (PGE 2 ) after capsulotomy creation using a femtosecond laser (FLAC) in patients pretreated with short-term topical ketorolac versus patients without pretreatment. Methods. is prospective study comprised consecutive patients scheduled to undergo cataract surgery using a femtosecond laser platform to perform only capsulotomies. An identical protocol for preoperative mydriasis was used for all the eyes included in the study, while aqueous humor was extracted from the anterior chamber of all patients immediately after the initial side port incision. ELISA was performed to quantify aqueous humor PGE 2 . e patients were divided into 2 groups; in group 1, the patients received short-term topical ketorolac preoperatively, while the patients in group 2 did not receive NSAID pretreatment. Results. Twenty eyes of 20 patients were included in the study (10 eyes in each group). Mean concentration of aqueous humor PGE 2 after FLAC was 392.16 ± 162.00 pg/ml and 622.63 ± 331.84pg/ml for groups 1 and 2, respectively. A statistically significant difference in aqueous humor PGE 2 concentration between the two groups (p < 0.05) was demonstrated, with the eyes that received ketorolac pretreatment demonstrating a lower concentration of PGE 2 . Conclusion. Short-term topical use of ketorolac prior to FLAC seems to prevent excessive release of PGE 2 in the anterior chamber of the eyes that received NSAID pretreatment when compared to the eyes that did not receive NSAIDs preoperatively. 1. Introduction Cataract surgery requires sufficient mydriasis, to facilitate capsulorhexis or capsulotomy, phacoemulsification, and finally intraocular lens insertion. Even though all patients undergoing cataract surgery receive preoperatively topical mydriatic agents, intraoperative pupillary miosis may occur due to the release of inflammatory mediators (prostaglan- dins) or due to iris surgical trauma [1] Miotic pupils during cataract surgery have been associated with increased com- plication rates during cataract surgery, leading in some cases in visual loss [2, 3]. e pretreatment with femtosecond laser-assisted cat- aract surgery (FLACS) platforms during cataract surgery has been associated with pupillary miosis [4–6]; the latter has been attributed to the increase of inflammatory mediator (prostaglandins) concentration in the anterior chamber (AC) after FLACS [7, 8]. Recent studies have demonstrated that short-term topical NSAIDs as a pretreatment prior to FLACS results in less prostaglandin release in the AC [9], and also NSAID pretreatment seems to induce significantly less pupillary miosis when compared to the eyes that did not receive NSAID prior to FLACS [10, 11]. e patients in the study assessing prostaglandin quantification in the AC Hindawi Journal of Ophthalmology Volume 2018, Article ID 1891249, 4 pages https://doi.org/10.1155/2018/1891249