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Raffaele Turano, Andrea Russo, Sara Vezzoli, Francesco Morescalchi, Marzia Bernini, Francesco De Ferrari, Ciro Costagliola, Francesco Semeraro; Vitreous Nonsteroidal Anti-Inflammatory Drug Levels in Vitrectomy Patients Treated with Topical Indomethacin 0.5%, Nepafenac 0.1%, and Bromfenac 0.09%. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5739. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the vitreous penetration of topical indomethacin 0.5%, nepafenac 0.1%, and bromfenac 0.09% in patients previously scheduled to undergo pars plana vitrectomy.
This was a single-center, double-masked observational study of 50 eyes of 50 patients. The first 40 eyes were randomized to one of three nonsteroidal anti-inflammatory drugs (NSAID) treatment arms. Patients were instructed to take the NSAID three times a day for 7 days before pars plana vitrectomy. The next 10 eyes were untreated and served as controls. Vitreous samples were immediately stored at -20°C prior to analysis. Vitreous NSAID concentrations were quantified using a liquid chromatography mass spectroscopy system.
Fifty eyes were included in the analysis. The mean (SD) vitreous concentrations were as follows: indomethacin 0.46 (0.52) ng/mL, nepafenac 0.29 (0.14) ng/mL, and bromfenac 0.30 (0.10) ng/mL. Respectively, the mean concentrations for phakic and pseudophakic eyes were 0.21 (0.28) ng/mL and 0.75 (0.62) ng/mL for indomethacin, 0.17 (0.04) ng/mL and 0.39 (0.12) ng/mL for nepafenac, and 0.21 (0.04) ng/mL and 0.36 (0.09) ng/mL for bromfenac (for all comparisons, P < 0.05).
All three NSAIDs penetrated into the vitreous. Vitreous levels of topical indomethacin 0.5%, nepafenac 0.1%, and bromfenac 0.09% were significantly higher in pseudophakic eyes than in phakic eyes.
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