PMID: 2508124Jan 1, 1989Paper

The putative role of prostaglandins in surgical miosis

Progress in Clinical and Biological Research
C B Camras, O C Miranda

Abstract

Most clinical studies demonstrate a small (0.5-1.0 mm) but significant reduction of surgical miosis by cyclooxygenase inhibitors (COIs), such as indomethacin, flurbiprofen, or suprofen. However, other studies failed to show significant inhibition by some of these agents. While this inhibition may provide a clinically useful advantage in some cases, it does not help us clarify the mediators and mechanism of the miotic response. The inhibitory effect of high doses of COIs on surgical miosis has generally been explained on the basis of inhibition of PG synthesis. However, COIs do not selectively inhibit the synthesis of PGs; they inhibit the synthesis of all cyclooxygenase products, including prostacyclin and thromboxanes. The reduction of the miotic response could also have resulted, in part, from inhibition of the lipoxygenase pathway of arachidonic acid metabolism. The effect of COIs on unrelated biochemical processes that influence the contractile responses of the iris sphincter may also have contributed to the inhibition of surgically induced miosis. In short, the mechanism by which COIs reduce miosis remains unidentified. If one assumes that PGs are the only mediators of this miosis, one must also assume that failure of COIs...Continue Reading

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