[Effect of diclofenac and flurbiprofen on the course of inflammation after cataract extraction].

In a prospective, randomized, double-blind study the effect of different anti-inflammatories (diclofenac 0.1%, flurbiprofen 0.03%) versus placebo on the intra- and postoperative inflammation in 65 eyes was examined. Prednisolone acetate 0.5% eye drops were the basic therapy in all three groups. As criteria served the difference between pre- and postoperative flare and cell concentration in the anterior chamber, measured using the laser flare cell meter, the clinical course, and the level of the inflammatory mediator 6-oxo-PGF1 alpha (prostacyclin) in the aqueous humor after intraoperative paracentesis, determined by means of enzyme-linked immunosorbent assay. The level of prostacyclin was not influenced in any of the three groups. The numbers of cells decreased continuously, but without marked differences among the groups. On the basis of the concentration of protein measured in the aqueous humor and the clinical course, diclofenac 0.1% proved to be a more potent additive anti-inflammatory therapy than flurbiprofen 0.03% immediately after the surgical procedure (P = 0.039 at 1 day after operation), but the final results (4 weeks after operation) revealed no detectable difference. By application of placebo, an obvious higher concentration of protein was measured during all the observations (P = 0.0002). Therefore in the case of cataract extraction the local steroidal therapy should be combined with nonsteroidal anti-inflammatory drugs (cyclooxygenase inhibitors).