Effect of prophylactic nonsteroidal antiinflammatory drugs on cystoid macular edema assessed using optical coherence tomography quantification of total macular volume after cataract surgery.
OBJECTIVE
To evaluate the efficacy of prophylactic administration of the topical nonsteroidal antiinflammatory drug (NSAID) ketorolac tromethamine 0.5% on acute (within 4 weeks of surgery) cystoid macular edema (CME) and total macular volume (TMV) in patients having phacoemulsification cataract surgery.


METHODS
Department of Ophthalmology, Queen's University, Hotel Dieu Hospital, Kingston, Ontario, Canada.


METHODS
This open-label nonmasked randomized (random number assignment) study comprised 106 eyes of 98 patients. Exclusion criteria included hypersensitivity to the NSAID drug class, aspirin/NSAID-induced asthma, and pregnancy in the third trimester. Ketorolac tromethamine 0.5% was administered starting 2 days before surgery and for 29 days after surgery for a total of 31 days. The outcome measure was macular swelling, which was quantified by the optical coherence tomography.


RESULTS
At 1 month, there was a statistically significant difference in TMV between the control group (0.4420 mm3) and the ketorolac group (0.2392 mm3), with the ketorolac group having 45.8% less macular swelling (P = .009). Multiple linear regression with backward selection indicated a 44.3% (P = .013) and 46.1% (P = .030) reduction in macular swelling in the ketorolac group at 1 week and 1 month, respectively.


CONCLUSIONS
Used prophylactically after cataract surgery, ketorolac 0.5% was efficacious in decreasing postoperative macular edema.
Almeida
David R P
DR
Department of Ophthalmology, Queen's University, Hotel Dieu Hospital, Kingston, Ontario, Canada.
Johnson
Davin
D
Hollands
Hussein
H
Smallman
Donald
D
Baxter
Stephanie
S
Eng
Kenneth T
KT
Kratky
Vladimir
V
ten Hove
Martin W
MW
Sharma
Sanjay
S
El-Defrawy
Sherif
S
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D020911:Ketorolac Tromethamine / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011239:Prednisolone / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020911:Ketorolac Tromethamine; D011239:Prednisolone