Evaluation of 0.4% ketorolac tromethamine ophthalmic solution versus 0.5% ketorolac tromethamine ophthalmic solution after phacoemulsification and intraocular lens implantation

• Published in: Journal of ocular pharmacology and therapeutics Vol. 22; no. 4; p. 251
• Main Authors: Sandoval, Helga P, De Castro, Luis E Fernández, Vroman, David T, Solomon, Kerry D
• Format: Journal Article
• Language: English
• Published: United States 01-08-2006
• Subjects: Aged; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - adverse effects; Double-Blind Method; Drug Evaluation; Female; Humans; Inflammation - drug therapy; Inflammation - physiopathology; Intraocular Pressure - drug effects; Ketorolac Tromethamine - administration & dosage; Ketorolac Tromethamine - adverse effects; Lens Implantation, Intraocular; Male; Ophthalmic Solutions - administration & dosage; Ophthalmic Solutions - adverse effects; Patient Satisfaction; Phacoemulsification; Postoperative Complications; Prospective Studies; Treatment Outcome; Uveitis, Anterior - drug therapy; Uveitis, Anterior - physiopathology; Visual Acuity - drug effects
• DOI: 10.1089/jop.2006.22.251
• ISSN: 1080-7683

The aim of this study was to compare the effectiveness and patient tolerance of 0.4% ketorolac tromethamine ophthalmic solution and 0.5% ketorolac tromethamine ophthalmic solution after routine phacoemulsification and lens implantation.
The setting for this study was the Storm Eye Institute and Magill Research Center for Vision Correction, Medical University of South Carolina (Charleston, SC).
This work was a prospective, double-masked study that included 40 eyes of 40 patients randomly assigned to receive topical treatment with 0.4% ketorolac or 0.5% ketorolac, starting 15 min prior to routine phacoemulsification and foldable posterior chamber intraocular lens implantation. Following the procedure, patients were instructed to use the assigned treatment agent 4 times a day after surgery for 1 week and twice a day for 3 weeks, when drops were discontinued. Slit-lamp examination, intraocular pressure (IOP), laser cell and flare measurements, and subjective patient tolerance were evaluated postoperatively at 1, 7, and 30 d. Comparisons between the 2 groups were made at each visit, as well as comparisons to baseline. A P=value less than .05 was considered statistically significant.
At day 1, a higher percentage of patients (70% vs. 40%) reported symptoms (mainly foreign body sensation and stinging/burning) in the 0.5% ketorolac group, compared to the 0.4% ketorolac group. No significant differences were found between the 2 groups over time regarding best-corrected visual acuity (BCVA), IOP, slit-lamp assessment of cells, and cell and flare measured using the laser cell/flare meter.
Treatment with 0.4% ketorolac tromethamine ophthalmic solution is as effective as 0.5% ketorolac tromethamine ophthalmic solution in reducing inflammation after routine cataract surgery. Patients reported less discomfort using 0.4% ketorolac.