Prostaglandin E2 inhibition and aqueous concentration of ketorolac 0.4% (acular LS) and nepafenac 0.1% (nevanac) in patients undergoing phacoemulsification.
OBJECTIVE
To determine the prostaglandin E(2) (PGE(2)) levels and aqueous concentrations achieved with ketorolac 0.4% (Acular LS; Allergan, Inc, Irvine, California, USA) and nepafenac 0.1% (Nevanac; Alcon Laboratories, Inc, Fort Worth, Texas, USA).


METHODS
Single-center, randomized, double-masked study.


METHODS
One hundred and thirty-two patients received ketorolac or nepafenac four times daily for two days before cataract extraction. Aqueous samples obtained at surgery were analyzed for PGE(2) levels (competitive enzyme immunoassay) and drug concentrations.


RESULTS
More ketorolac eyes than nepafenac eyes had PGE(2) levels less than the level of detection (<100 pg/ml; 26/42 [61.9%] and 7/40 [17.5%], respectively; P < .001). Mean PGE(2) levels in ketorolac eyes were lower than that in nepafenac eyes (159.5 +/- 114.66 pg/ml and 322 +/- 197.8 pg/ml, respectively; P < .001). The mean aqueous level was 1079.1 +/- 881.5 ng/ml with ketorolac and 353.4 +/- 126.0 ng/ml with amfenac. The nepafenac eyes exhibited 588.4 +/- 394.6 ng/ml of the inactive nepafenac molecule (P < .001 vs ketorolac).


CONCLUSIONS
Ketorolac 0.4% inhibited PGE(2) and penetrated into aqueous significantly more than nepafenac 0.1%.
Bucci
Frank A
FA
Bucci Laser Vision Institute, Wilkes Barre, Pennsylvania 18702, USA. buccivision@aol.com
Waterbury
L David
LD
Amico
Loretta M
LM
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000493:pharmacokinetics*; D001082:Aqueous Humor / Q000378:metabolism*; D044482:Benzeneacetamides / Q000493:pharmacokinetics*; D001682:Biological Availability; D002851:Chromatography, High Pressure Liquid; D015232:Dinoprostone / Q000037:antagonists & inhibitors*; D004311:Double-Blind Method; D006801:Humans; D007124:Immunoenzyme Techniques; D020911:Ketorolac Tromethamine / Q000493:pharmacokinetics*; D013058:Mass Spectrometry; D018918:Phacoemulsification; D010648:Phenylacetates / Q000493:pharmacokinetics*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D044482:Benzeneacetamides; D010648:Phenylacetates; C414203:nepafenac; D020911:Ketorolac Tromethamine; D015232:Dinoprostone