Effect of topical diclofenac and ketorolac on patient discomfort and corneal sensitivity.
OBJECTIVE
To determine if at clinical dosages, the topical nonsteroidal anti-inflammatory drugs diclofenac and ketorolac decrease corneal sensitivity, and if there is a difference in discomfort on instillation.


METHODS
In a double-masked study, 30 patients were randomized to receive two of three topical drops, Endosol, diclofenac sodium, and ketorolac tromethamine. A microaesthesiometer was used to evaluate corneal sensation. Baseline corneal sensitivity was obtained on each patient. Corneal sensory thresholds were remeasured at 7 and 15 minutes following eyedrop application. Patients also completed a questionnaire that graded the burning caused by the medications.


RESULTS
No significant decrease in corneal sensory thresholds was found with diclofenac or ketorolac compared with control at baseline (P = .50), 7 minutes (P = .41), or 15 minutes (P = .82). There was significantly more burning with diclofenac and ketorolac compared to control. There was a small but not statistically significant (P = .28) trend of more burning with ketorolac than diclofenac.


CONCLUSIONS
Neither diclofenac nor ketorolac were found to decrease corneal sensation compared to control. There was no significant difference in burning upon instillation reported by patients.
Narváez
Julio
J
Turlock Eye Physicians Medical Group, CA, USA. narvaez@evestamail.com
Kroll
Peter
P
Guzek
James P
JP
D000287:Administration, Topical; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000494:pharmacology*; D003315:Cornea / Q000187:drug effects / Q000502:physiology*; D004008:Diclofenac / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020911:Ketorolac Tromethamine / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D017060:Patient Satisfaction; D012677:Sensation / Q000187:drug effects*; D012684:Sensory Thresholds / Q000187:drug effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D004008:Diclofenac; D020911:Ketorolac Tromethamine