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Masakazu Yamada, MD; Masaro Ogata, MD; Masataka Kawai, MD; Hiroshi Mochizuki, MD; Yukihiko Mashima, MD

Arch Ophthalmol. 2002;120:51-54.

Objective  To explore the mechanism by which diclofenac sodium eyedrops exert an adverse effect on the cornea.

Methods  In 10 healthy Japanese volunteers, 0.1% diclofenac sodium solution was instilled into one eye 3 times daily for 2 weeks. Only vehicle was applied to the other eye. Tear samples were taken before drug treatment, at 2 weeks (on the final day of treatment), and at 4 weeks. Prostaglandin E₂ and substance P concentrations in tears were measured using enzyme immunoassays.

Results  After treatment for 2 weeks, concentrations of both prostaglandin E₂ and substance P in tears from diclofenac sodium–treated eyes had decreased significantly, and both had returned to baseline levels by 4 weeks. No significant changes were seen in prostaglandin E₂ and substance P levels in vehicle-treated eyes at any time points.

Conclusions  Diclofenac sodium eyedrops concurrently reduced concentrations of prostaglandin E₂ and substance P in tears. Depletion of substance P (a pain-associated neurotransmitter) by diclofenac sodium may promote development of corneal complications.

From the Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. The authors have no proprietary interest in any materials mentioned in this article.