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Year : 1979  |  Volume : 27  |  Issue : 4  |  Page : 59-60

Effect of non-steroidal anti-inflammatory drugs on blood aqueous barrier in human eyes

S.M.S. Medical College, Jaipur, India

Correspondence Address:
O P Kulshrestha
Professor of Ophthalmology, S.M.S. Medical College, Jaipur
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Kulshrestha O P, Khuteta A, Chundawat H S. Effect of non-steroidal anti-inflammatory drugs on blood aqueous barrier in human eyes. Indian J Ophthalmol 1979;27:59-60

How to cite this URL:
Kulshrestha O P, Khuteta A, Chundawat H S. Effect of non-steroidal anti-inflammatory drugs on blood aqueous barrier in human eyes. Indian J Ophthalmol [serial online] 1979 [cited 2020 Nov 30];27:59-60. Available from: https://www.ijo.in/text.asp?1979/27/4/59/32577

Table 1

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Table 1

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Paracentesis has been employed to break down blood-aqueous barrier. A direct com­parison can thus be made between primary aqueous humour collected immediately on para­centesis and secondary aqueous humour formed, some minutes after opening the anterior chamber.

Very limited information is available in the literature on the effect of non-steroid anti­inflammatory agents in traumatic uveal inflam­mation. Our aim here was to assess the anti inflammatory efficacy of these drugs as reflected on the degree of break down of blood aqueous barrier and estimated from the protein content of the aqueous.

  Materials and Methods Top

Forty patients of cataract to be operated upon were the subjects of this study. They were divided into 4 groups of 10 patients each. Group I: no medication. The patients of Group Ii, Gr. III and Gr. IV were administered doses of Aspirin 600 mg Indomethacin 50 mg and paracetamol 1000 mg respectively every 4 hours for 12 hours with an additional dose half an hour before operation.

Paracentesis was selected as a means of trauma to activate inflammation. After routine local anaesthesia 0.1 ml. sample aqueous humor was withdrawn with a tuberculine syringe with 27 gauge needle. All manipula­tions were stopped for 5 minutes. At the end of 5 minutes, another sample of 0.1 ml, of aqueous humor was taken before actual starting of cataract surgery. The protein content in aqueous humor before and after surgical trauma was estimated in all the cases by using Biuret reaction (Kingsley's Method, 1939).

Simultaneously, in order to estimate the serum levels of all the three drugs, 5 0 ml. of blood sample was taken out from every patient and serum separated. Serum samples collected were analysed to know the drug concentration of aspirin as salicylates, indomethacin as indole and paracetamol as para-aminophenol.


Group 1: The average aqueous humor protein con­tent before trauma (Paracentesis (was 72.9 mg per cent and 5 minutes after paracentesis it increased to 27.4 mg. percent. There was thus an increase in proteins by 74.57 per cent in those who had no drug prior to paracentesis.

Group II: The average initial protein level of aqueous was 73.9 mg percent in the group pre-treated with aspirin, which went up to 85.0 mg per cent, after paracentesis, showing a mean increase of 16.4 per cent. The average level of drug in blood measured as serum salicylate was 14.1 mg per cent.

Group III: In indomethacin pre-treated group the average aqueous protein content of aqueous initially was 84.3 mg per cent and after paracentesis it increased to 106.3 mg percent, with mean rise of 29.41 per cent. The average level of drug in blood measured as serum indole was 1.34 microgram/ml.

Group IV: In paracetamol pre-treated group average initial protein content was 54.7 mg per cent and after paracentesis 92.3 mg per cent. There was thus an increase in protein content by 72.30 per cent. The average blood concentration of the drug measured as serum para aminophenol in 31.1 microgram/ml.

  Discussion Top

Anti-inflammatory effect of aspirin, by knowing the amount of protein effusion in anterior chamber has been assessed and com­pared with control group as shown in [Table - 1].

The anti-inflammatory effect of aspirin as reflected in percentage charge protein content of the secondary aqueous (following paracentesis) was found to be most pronounced (P<0.001); that of indomethacin was less pronounced but significant (P <0.001). But the anti-inflammatory effect of paracetamol was negligible (P>0.6).

  Summary and conclusions Top

Anti-inflammatory property of aspirin, indomethacin and paracetamol has been studied in human eyes by pre-treatment with these drugs and analysis of proteins carried out in aspirated aqueous after initial paracentesis and 5 minutes after this local trauma induced by para­centesis. This has been compared with the control group. Aspirin and indomethacin showed high degree of anti inflammatory response as revealed by comparatively lesser increase in protein content of aqueous. Para­cetamol showed very poor or no anti-inflamma­tory effect.

No correlation was noted between the level of these drugs reached in the serum and propor­tionate fall or change in aqueous protein on the same patient or patients of the same group.


  [Table - 1]


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