The effect of indomethacin 1% ophthalmic suspension in preventing surgically induced miosis at extracapsular cataract surgery.

27 patients who underwent extracapsular cataract surgery (ECCE) were randomized in two groups with 12 patients in Group 1 treated with standard preoperative dilation regime and 15 patients in Group 2 receiving in addition Indomethacin 1% ophthalmic solution, one drop the evening before surgery and one drop 45 minutes before surgery. Horizontal pupillary diameter measurements were taken at the beginning of the operation before retrobulbar anesthesia, before capsulotomy, and before lens implantation. A significant decrease in pupillary diameter and area was seen in both groups (P greater than 0.001; t-test) from before capsulotomy until before lens implantation. No significant change was seen from start until before capsulotomy. A significant lesser pupillary constriction expressed as mean calculated pupillary area differences from start until before lens implantation was seen in Group 2 treated with indomethacin (17.70 +/- 6.68(mm)2), than in Group 1 without indomethacin (29.06 +/- 8.82(mm)2); (P greater than 0.05; t-test). It is concluded that local use preoperatively of the antiprostaglandin drug indomethacin in 1% ophthalmic solution (Indocid, MSD) is able to reduce surgically induced miosis during ECCE, thereby facilitating the operative procedure and probably minimizing complications.