title: Corneal ulceration and perforation with ketorolac tromethamine (Acular) use after PRK.
abstract: OBJECTIVE
  To report a case of corneal ulceration and perforation after PRK connected with high doses of ketorolac tromethamine (Acula).
  
  
  METHODS
  A 31-year-old man presented 5 days after PRK in the left eye with corneal ulceration and perforation requiring penetrating keratoplasty. The patient admitted to using Acular every hour, ciprofloxocin every hour, and prednisolone acetate 1% QID postoperatively.
  
  
  RESULTS
  Laboratory tests, including corneal cultures, were normal. A diagnosis of corneal ulceration secondary to incorrect use of high-dose ketorolac tromethamine was made.
  
  
  CONCLUSIONS
  Judicious patient counseling is recommended when using topical NSAIDs in the setting of PRK.
authors.affiliation: University of Michigan, W. K. Kellogg Eye Center, Ann Arbor, Michigan 48105, USA. smian@med.umich.edu
authors.forename: Shahzad I
authors.initials: SI
authors.lastname: Mian
authors.forename: Anjali
authors.initials: A
authors.lastname: Gupta
authors.forename: Roberto
authors.initials: R
authors.lastname: Pineda
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D003315:Cornea / Q000187:drug effects / Q000473:pathology* / Q000601:surgery; D003320:Corneal Ulcer / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating; D020911:Ketorolac Tromethamine / Q000008:administration & dosage / Q000009:adverse effects*; D054018:Lasers, Excimer; D008297:Male; D009883:Ophthalmic Solutions; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications; D012086:Reoperation; D012422:Rupture, Spontaneous / Q000139:chemically induced
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D020911:Ketorolac Tromethamine