title: Effect of ketorolac add-on treatment on intra-ocular pressure in glaucoma patients receiving prostaglandin analogues.
abstract: OBJECTIVE
  While topical ocular hypotensive agents cause secretion of endogenous prostaglandin (PG), systemic and topical non-steroidal anti-inflammatory agents inhibit its production; thus, they may interfere with therapeutic efficacy. This study aimed to investigate the effect of add-on treatment with ketorolac on intra-ocular pressure (IOP)-lowering effects of three different PG analogues.
  
  
  METHODS
  This study included 30 adult bilateral glaucoma patients who had been receiving PG analogues for primary open-angle glaucoma (n = 25) or pseudoexfoliation glaucoma (n = 5). Ketorolac tromethamine 0.5% and placebo drops were administered to the right and left eyes of the patients, respectively, 4 times a day for 1 week. IOP measurements were performed at baseline, within the first 4 h after application, on days 1, 3 and 7, and 1 and 7 days after discontinuation of the treatment.
  
  
  RESULTS
  Eyes receiving ketorolac had significantly lower IOP throughout the treatment period (p < 0.001). Patients who were on latanoprost, travoprost and bimatoprost did not differ with regard to the change in IOP (p = 0.780). After discontinuation, pressures became similar on day 1 (p = 0.796) and day 7 (p = 0.314).
  
  
  CONCLUSIONS
  In glaucoma patients, ketorolac significantly enhances the IOP-lowering effects of latanoprost, travoprost and bimatoprost.
authors: Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey.
authors: Ece
authors: E
authors: Turan-Vural
authors: Banu
authors: B
authors: Torun-Acar
authors: Suphi
authors: S
authors: Acar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D000069580:Bimatoprost; D003008:Cloprostenol / Q000008:administration & dosage / Q000031:analogs & derivatives; D004359:Drug Therapy, Combination; D017889:Exfoliation Syndrome / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D020911:Ketorolac Tromethamine / Q000627:therapeutic use*; D000077338:Latanoprost; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011455:Prostaglandins A, Synthetic / Q000008:administration & dosage*; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage; D014065:Tonometry, Ocular; D000069557:Travoprost
chemical_list: D000577:Amides; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000959:Antihypertensive Agents; D011455:Prostaglandins A, Synthetic; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; D020911:Ketorolac Tromethamine; D000077338:Latanoprost; D000069580:Bimatoprost; D000069557:Travoprost