ABSTRACT
To assess the relative efficacy of indomethacin as a drug that prevent intraoperative miosis and the best method of its administration and pharmacological analysis of its level in aqueous, blood and iris tissue. This study was done in Tanta University Eye Hospital and for it, sixty patients for whom ECCE and IOL implantation was planned to be done, were selected. The patients were divided into 6 groups according to the method of indomethacin administration whether 1% eye suspension, oral depocaps 75 mg, suppositories 100 mg or combinations of suspension with either depocaps or suppositories and another control group. All the patients were prepared for ECCE and preoperative mydriatics were used. The pupil diameter was recorded preoperative, after lens matter wash and after IOL implantation. Aqueous tape was done before opening the anterior chamber and iridectomy piece was studied pharmacologically for indomethacin level. A blood sample was taken premedication and just preoperative for systemic detection of the drug. In all the groups in which indomethacin was used, mydriasis and indomethacin pharmacological level were significantly higher than control group. Still in the gps using depocaps gave the best results and the highest clinical and pharmacological results with no postoperative flare, but 10% of cases using oral indomethacin complained of drowsiness. It is concluded that the use of indomethacin whatever its method of administration has a role in preventing intraoperative miosis and suppress postoperative inflammation specially the depocaps 75 mg