title: Prophylactic use of ketorolac tromethamine in cataract surgery: a randomized trial.
abstract: OBJECTIVE
  To determine the efficacy of topical ketorolac tromethamine in preventing cystoid macular edema (CME) after uncomplicated cataract surgery.
  
  
  METHODS
  This single-center, prospective, double-masked, randomized clinical trial consisted of 81 patients who were scheduled for cataract surgery. Patients were randomized to receive hypromellose/dextran 70 as a placebo (n=44) or ketorolac tromethamine 0.4% (n=37) as an adjuvant therapy. These eye drops were administered 4 times daily (QID) for 3 days before surgery and 5 weeks postoperatively. All patients received prednisolone acetate 1% QID during the same period as basal/standard anti-inflammatory therapy. The primary outcome was the incidence of angiographic CME 5 weeks after surgery. The secondary outcomes were mean change in best-corrected visual acuity (BCVA) [Early Treatment Diabetic Retinopathy study (ETDRS)], clinical CME incidence, intraocular pressure, and retinal thickness measured using optical coherence tomography (OCT).
  
  
  RESULTS
  In the placebo group, 2/44 (4.5%) patients and in the ketorolac group, 2/37 (5.4%) patients presented with angiographic CME (P=0.624). The mean change in postoperative BCVA was 32±15 letters in the placebo group and 26±16 letters in the ketorolac group (P=0.07). There were no statistically significant between-group differences in the mean central subfield thickness (P=0.679), minimal central thickness (P=0.352), or central macular volume (P=0.729).
  
  
  CONCLUSIONS
  There was no difference between ketorolac tromethamine and a placebo with regard to BCVA results or prevention of CME after uncomplicated cataract surgery.
authors.affiliation: Department of Ophthalmology, University of Campinas (UNICAMP) , Campinas, São Paulo, Brazil .
authors.forename: Flavia G
authors.initials: FG
authors.lastname: Ticly
authors.forename: Rodrigo P C
authors.initials: RP
authors.lastname: Lira
authors.forename: Fernando R
authors.initials: FR
authors.lastname: Zanetti
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Machado
authors.forename: Gustavo B
authors.initials: GB
authors.lastname: Rodrigues
authors.forename: Carlos Eduardo L
authors.initials: CE
authors.lastname: Arieta
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D002387:Cataract Extraction / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020911:Ketorolac Tromethamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008269:Macular Edema / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D011239:Prednisolone / Q000031:analogs & derivatives / Q000627:therapeutic use; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D020911:Ketorolac Tromethamine; C009935:prednisolone acetate; D011239:Prednisolone