Topical ketorolac in vitreoretinal surgery: a prospective, randomized, placebo-controlled, double-masked trial.
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.
Kim
Stephen J
SJ
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA. skim30@gmail.com
Lo
Wayne R
WR
Hubbard
G Baker
GB
Srivastava
Sunil K
SK
Denny
John P
JP
Martin
Daniel F
DF
Yan
Jiong
J
Bergstrom
Chris S
CS
Cribbs
Blaine E
BE
Schwent
Bryan J
BJ
Aaberg
Thomas M
TM
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*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D020911:Ketorolac Tromethamine