Pupillary dilatation during cataract surgery--relative efficacy of indomethacin and flurbiprofen

In a prospective, randomized, double-blind trial, we evaluated the relative efficacy of indomethacin and flurbiprofen when used as adjuvants to routinely used mydriatics for maintenance of pupillary dilatation in patients with heavily pigmented iris undergoing extracapsular cataract extraction. The drugs were administered orally as well as topically according to a fixed regimen. The pupillary diameters, measured with calipers at various surgical steps, were significantly larger at every step in the study groups in which either of the adjuvants had been used than they were in the control group (P less than .001). Flurbiprofen tended to help maintain a larger pupillary diameter in the later stages of surgery than indomethacin, but this difference was not statistically significant. We conclude that it is important to use prostaglandin synthetase inhibitors as adjuvants to routine mydriatics, and that flurbiprofen may be somewhat more effective than indomethacin in this capacity.