[Anti-inflammatory effect of topical diclofenac sodium (Voltarène Ophta) after argon laser trabeculoplasty: preliminary results of a prospective double-blind method].
Using the laser flare-cell meter (LFMC), we have previously determined the intensity and pattern of post-ALT ocular inflammation. Inflammation peak occurs 48 hours after ALT and clinically relevant inflammation is seen in 100% of pigmentary glaucomas (PIG), 75% of pseudoexfoliative glaucomas (PEXG) but only in 25% of primary open angle glaucomas (POAG). We also showed that topical diclofenac reduced inflammation in all 17 treated patients. Prostaglandins are thought to play a major role in ALT-inflammation and it is therefore logical to assume that NSAID are effective in that situation and will probably advantageously replace corticosteroids. In order to assess the anti-inflammatory effect of diclofenac drops (Voltaren Ophtha) we included a total of 37 PIG or PEXG (19 in the diclofenac and 18 in the placebo group) scheduled for ALT in prospective randomized placebo-controlled study. Visual acuity, tonometry, and LFCM flare measure were performed before, 3, 6 hours, 1, 2, 4, 7, 14 days after ALT. Topical diclofenac or placebo was given before and after ALT and then QID for a total of 4 days. Mean maximal flare increase was significantly less in the diclofenac group than in the placebo group (4.6 +/- 3.8 ph/msec v. 17.4 +/- 19 ph/msec; p less than 0.01). Flare increase compared to pre-ALT values was significant at 1 and 2 days after ALT in the placebo group only (p less than 0.02; p less than 0.05); no significant flare increase occurred in the diclofenac group.(ABSTRACT TRUNCATED AT 250 WORDS)
Herbort
C P
CP
Hôpital Jules Gonin, Service d'ophtalmologie, Université de Lausanne.
Mermoud
A
A
Schnyder
C
C
Pittet
N
N
D000368:Aged; D000867:Anterior Chamber / Q000187:drug effects; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy*; D006801:Humans; D007249:Inflammation; D007429:Intraocular Pressure / Q000187:drug effects; D053685:Laser Therapy; D008297:Male; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000517:prevention & control*; D014130:Trabeculectomy
D009883:Ophthalmic Solutions; D004008:Diclofenac
Effet anti-inflammatoire du diclofenac sodium topique (Voltarène Ophta) après trabéculoplastie au laser argon (TLA): résultats préliminaires d'une étude prospective en double-insu.