Skip to main content
Log in

Prevention of cystoid macular edema after lens extraction by topical indomethacin (I)

A preliminary report

  • Published:
Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie Aims and scope Submit manuscript

Summary

Topically administered indomethacin was found to reduce the occurrence of cystoid macular edema after lens extraction. Indomethacin was given topically as 1% oil solution (sesame oil) eye drops twice or three times daily from the day before operation to the 40th day after operation. This effect suggests that prostaglandins play a leading role in the development of this disorder. It is postulated that operative irritation causes production of prostaglandins, which disrupt the blood-aqueous barrier, followed by an increase of the inflammatory mediators and debris in the aqueous. These inflammatory substances and prostaglandins themselves diffuse from the aqueous into the posterior pole of the fundus, where they induce inflammatory changes in vascular permeability in the perifoveolar capillary plexus. Clinically the cystoid macular edema then develops.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Ambache, N.: Irin, a smooth-musle contracting substance present in the rabbit iris. J. Physiol. (Lond.) 129, 65–66 (1955)

    Google Scholar 

  • Ambache, N.: Properties of irin, a physiological constituent of the rabbit's iris. J. Physiol. (Lond.) 135, 114–132 (1957)

    Google Scholar 

  • Ambache, N.: Further studies on the preparation, purification and nature of irin. J. Physiol. (Lond.) 146, 255–294 (1959)

    Google Scholar 

  • Ambache, N., Brummer, H.C., Rose, J.G., Whiting, J.: Thin-layer chromatography of spasmogenic unsaturated hydroxy acids from various tissues. J. Physiol. (Lond.) 185, 77–78 (1966)

    Google Scholar 

  • Ambache, N., Kavanagh, L., Whiting, J.: Effect of mechanical stimulation on rabbit's eyes: release of active substance in anterior chamber perfusates. J. Physiol. (Lond.) 176, 378–408 (1965)

    Google Scholar 

  • Araki, M.: Dynamics of vitreous humor. I. Drainage of the vitreous humor through the retinal capillaries. Acta Soc. Ophthalmol. Jap. 80, 1276–1284 (1976)

    Google Scholar 

  • Baurmann, H.: Fluorescein microscopy of eye tissue: success and failure. In: Fluorescein Angiography. Proceedings of I.S.F.A. Tokyo 1971 (K. Shimizu, ed.). Tokyo: Igakushoin 1974

    Google Scholar 

  • Bengtsson, E.: The inhibiting effect of indomethacin on the disruption of the bloodaqueous barrier in the rabbit eye. With a technical note: Measurement of the aqueous flare (C.E.T. Krakau, R. Öhman). Invest. Ophthal. 14, 306–312 (1975)

    Google Scholar 

  • Duke-Elder, S.: System of Ophthalmology, Vol. X. London: Kimpton 1971

    Google Scholar 

  • Ferreira, S.H., Moncada, S., Vane, J.R.: Indomethacin and aspirin abolish prostaglandin release from the spleen. Nature (New Biol.) 231, 237–239 (1971)

    Google Scholar 

  • Gass, J.M.D., Norton, E.W.D.: Fluorescein studies of patients with macular edema and papilloedema following cataract extraction. Trans. Amer. ophthal. Soc. 64, 232–249 (1966)

    Google Scholar 

  • Hanna, C., Sharp, J.D., Ark, R.L.: Ocular absorption of indomethacin by the rabbit. Arch. Ophthal. 88, 196–198 (1972)

    Google Scholar 

  • Hanna, C., Keatts, H.C.: Indomethacin in ocular inflammation in rabbits. Arch. Ophthal. 77, 554–558 (1967)

    Google Scholar 

  • Hanna, C.: Nonsteroid anti-inflammatory agents: Past and present. In: Ocular Antiinflammatory Therapy (H.E. Kaufman, ed.). Springfield: Charles C. Thomas 1970

    Google Scholar 

  • Hitchings, R.A., Chisholm, I.H., Bird, A.C.: Aphakic macular edema: Incidence and pathogenesis. Invest. Ophthal. 14, 68–72 (1975)

    Google Scholar 

  • Irvine, A.R.: Cystoid Maculopathy. Surv. Ophthal. 21, 1–17 (1976)

    Google Scholar 

  • Irvine, S.R.: A newly defined vitreous syndrome following cataract surgery. Amer. J. Ophthal. 36, 599–619 (1953)

    Google Scholar 

  • Jaffe, N.S.: Cataract surgery and its complications. St. Louis: Mosby 1976

    Google Scholar 

  • Kass, M.A.: Systemic aspirin and indomethacin do not prevent the response of the monkey eye to trauma. Invest. Ophthal. 14, 604–606 (1975)

    Google Scholar 

  • Kramer, S.G.: Retinal uptake of topical epinephrine in aphakia. In: Symposium on Ocular Therapy. Vol. 9 (I.H. Leopold, R.P. Burns, eds.). New York-LondonSydney-Toronto: Wiley 1975

    Google Scholar 

  • Maumenee, A.E.: Clinical entities in uveitis: An approach to the study of intraocular inflammation. Amer. J. Ophthal. 69, 1–27 (1970)

    Google Scholar 

  • Meredith, T.A., Kenyon, K.R., Singerman, L.J., Fine, S.L.: Perifoveal vascular leakage and macular oedema after intracapsular cataract extraction. Brit. J. Ophthal. 60, 765–769 (1976)

    Google Scholar 

  • Miller, J.D., Eakins, K.E., Atwal, M.: The release of prostaglandin-like activity into aqueous humor after paracentesis and its prevention by aspirin. Invest. Ophthal. 12, 939–941 (1973)

    Google Scholar 

  • Neufeld, A.H., Sears, M.L.: The site of action of Prostaglandin E2 on the disruption of blood-aqueous barrier in rabbit eye. Exp. Eye Res. 17, 445–448 (1973)

    Google Scholar 

  • Sawa, M., Masuda, K.: Topical indomethacin in soft cataract aspiration. Jap. J. Ophthal. 20, 514–519 (1976)

    Google Scholar 

  • Sears, M.L.: Use of aspirin and aspirin-like drugs in ophthalmology. In: Symposium on Ocular Therapy. Vol. 7 (I.H. Leopold, ed.). St. Louis: Mosby 1974

    Google Scholar 

  • Sears, M.L., Neufeld, A.H., Jampol, L.M.: Prostaglandins. Invest. Ophthal. 12, 161–164 (1973)

    Google Scholar 

  • Tennant, J.L.: Is cystoid macular edema reversible by oral indocin, Yes or no? In: Current Concepts in Cataract Surgery (J.M. Emery, D. Paton, eds.). St. Louis: Mosby 1976

    Google Scholar 

  • Vane, J.R.: Inhibition of Prostaglandin synthesis as a mechanism of action for aspirinlike drugs. Nature (New Biol.) 231, 232–235 (1971)

    Google Scholar 

  • Waitzman, M.B.: Possible new concepts relating PG to various ocular functions. Surv. Ophthal. 14, 301–326 (1970)

    Google Scholar 

  • Yoshioka, H., Kawashima, K.: Macular edema following cataract extraction. Acta Soc. Ophthal. Jap. 75, 2269–2273 (1971)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Miyake, K. Prevention of cystoid macular edema after lens extraction by topical indomethacin (I). Albrecht von Graefes Arch. Klin. Ophthalmol. 203, 81–88 (1977). https://doi.org/10.1007/BF00413399

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00413399

Keywords

Navigation