title: Topical ketorolac in vitreoretinal surgery: a prospective, randomized, placebo-controlled, double-masked trial.
abstract: OBJECTIVE
  To evaluate the effects of topical ketorolac in patients undergoing vitreoretinal surgery.
  
  
  METHODS
  One hundred nine patients undergoing vitrectomies were randomized to receive either topical ketorolac tromethamine, 0.4%, or placebo. Patients were instructed to begin taking the study medication 3 days preoperatively (4 times daily) and to continue taking it 4 weeks postoperatively.
  
  
  METHODS
  Intraoperative pupil diameter, postoperative day 1 pain and inflammation, 1-month postoperative retinal thickness, and preoperative and 1-month postoperative best-corrected visual acuities.
  
  
  RESULTS
  The difference in mean pupil diameters between patients using ketorolac and those taking placebo was 0.06 mm (P = .39). Patients taking ketorolac and those taking placebo had mean pain scores (scale, 1-10) of 0.24 (SD, 0.6) and 1.06 (SD, 2) (P = .03) and mean inflammation grades (grade, 0-4) of 0.59 (SD, 0.7) and 1.16 (SD, 0.9) (P < .001), respectively. Ketorolac reduced central subfield thickness by 8%, but this was not statistically significant. At 1 month, mean visual acuities improved to 0.40 logMAR units (mean Snellen, 20/50; SD, 0.28 logMAR units) in the ketorolac group from 0.83 logMAR units (20/150(+2); SD, 0.60 logMAR units) at baseline and to 0.67 logMAR units (20/100(+1); SD, 0.46 logMAR units) in the placebo group from 0.92 logMAR units (20/150(-2); SD, 0.62 logMAR units) at baseline (P = .001).
  
  
  CONCLUSIONS
  Topical ketorolac was well tolerated and safe, reduced postoperative pain and inflammation, and improved visual recovery in this prospective, double-masked trial.
  
  
  CONCLUSIONS
  Topical ketorolac may benefit patients undergoing vitreoretinal surgery.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00576329.
authors.affiliation: Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA. skim30@gmail.com
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kim
authors.forename: Wayne R
authors.initials: WR
authors.lastname: Lo
authors.forename: G Baker
authors.initials: GB
authors.lastname: Hubbard
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Srivastava
authors.forename: John P
authors.initials: JP
authors.lastname: Denny
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Martin
authors.forename: Jiong
authors.initials: J
authors.lastname: Yan
authors.forename: Chris S
authors.initials: CS
authors.lastname: Bergstrom
authors.forename: Blaine E
authors.initials: BE
authors.lastname: Cribbs
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Schwent
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Aaberg
mesh_terms: D000287:Administration, Topical; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D020911:Ketorolac Tromethamine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects; D012164:Retinal Diseases / Q000601:surgery*; D014792:Visual Acuity / Q000187:drug effects; D014821:Vitrectomy; D014822:Vitreous Body / Q000601:surgery*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D020911:Ketorolac Tromethamine