フルルビプロフェン点眼液の白内障手術中の散瞳維持効果と術後炎症に対するフレアセルメーターを用いた定量的検討

Effect of topical flurbiprofen on maintenance of mydriasis during cataract surgery and on postoperative inflammation

　プロスタグランディン合成阻害薬であるフルルビプロフェン（FP）点眼液の，白内障手術中の散瞳維持効果および，術後炎症抑制効果を検討した。対象は，老人性白内障28眼で，FP濃度0,0.0025,0.025,0.1％のいずれかを術前4回，術後3回／日点眼とした。術中の縮瞳率を測定し，術後1か月間レーザーフレアセルメーターにより術後炎症度を検討した。縮瞳率はFP高濃度群（0.1％，0.025％）で低濃度群（0.0025％，0％）より有意に低かった（P＜0.05）。術後フレア値は術翌日にFP高濃度群が低濃度群に比し有意に低かったが（P＜0.05），2日目以後は有意差がなかった。高濃度のFPは白内障手術中の散瞳維持および術後炎症抑制に有効な薬剤である。

We evaluated the effect of topical flurbiprofen during and after cataract surgery. Extracapsular cataract extraction with intraocular lens implanta-tion was performed in 28 eyes by a same surgeon. Each eye received either of 0 %, 0.0025 %, 0.025 % or 0.1 % flurbiprofen ophthalmic solution 4 times daily before and 3 times daily after surgery. Pupil size was measured immediately after anterior cap-sulotomy and after aspiration of lens cortex. Pro-tein concentration and cells in the anterior chamber were quantitated 7 times during the ensuing 1month using a laser flare-cell meter. There was a significantly low incidence of miosis during surgery when 0.1 % or 0.025 % flurbiprofen was used than 0.0025 % or 0 % (p＜0.05). The protein con-centraion on the first postoperative day was signifi-cantly lower receiving higher concentration flurbi-profen (p ＜0.05) . There was no difference from the second postoperative day on regarding protein concentration. Flurbiprofen did not influence the number of cells throughout. Instillation of 0.025 % or 0.1 % flurbiprofen was thought to be effective for maintenance of mydriasis during surgery and for suppression of postoperative inflammation.