title: [Efficacy of topical ketorolac for improving visual function after photocoagulation in diabetic patients with focal macular edema].
abstract: BACKGROUND
  Photocoagulation reduces the incidence of visual loss in diabetic patients with focal macular edema, but it can induce it for Efficacy of topical ketorolac for improving visual function after photocoagulation in diabetic patients with focal macular edema 6 weeks after treatment and produces visual improvement in some cases. Topical ketorolac may reduce the inflammation caused by photocoagulation and improve visual outcome.
  
  
  OBJECTIVE
  To determine the efficacy of topical ketorolac for improving visual function after photocoagulation in diabetic patients with focal macular edema.
  
  
  METHODS
  An experimental, comparative, prospective, longitudinal study in diabetic patients with focal macular edema was conducted. Eyes were randomized into two groups of topical treatment for 3 weeks after photocoagulation (A: ketorolac, B: placebo). Best corrected visual acuity before and after treatment was compared in each group (paired t test), and the proportion of eyes with visual improvement was compared between groups (χ(2)). The evaluation was repeated after stratifying for initial visual acuity (≥ 0.5, < 0.5).
  
  
  RESULTS
  There were 105 eyes included. In group A (n= 46) mean visual acuity changed from 0.50 to 0.58 (p= 0.003), and from 0.55 to 0.55 in group B (n= 59, p= 0.83); mean percent change was 22.3% in group A and 3.5% in group B (p= 0.03). Visual improvement was identified in 25 eyes from group A (54.3%) and 19 from group B (32.2%, p= 0.019, RR 1.65); the difference only persisted when initial visual acuity was ≥ 0.5 (10 [40%], group A, 5 [14.7%], group B, p= 0.02, RR 2.72).
  
  
  CONCLUSIONS
  Topical ketorolac was more effective than placebo to improve best corrected visual acuity in diabetic patients with focal macular edema.
authors.affiliation: División de Investigación. Hospital Juárez de México, México DF, Mexico.
authors.forename: Dulce Milagros
authors.initials: DM
authors.lastname: Razo Blanco-Hernández
authors.affiliation: Servicio de Oftalmología, Hospital Juárez de México, México DF, Mexico. vlimag@eninfinitum.com.
authors.forename: Virgilio
authors.initials: V
authors.lastname: Lima-Gómez
authors.affiliation: Sección de Estudios de Posgrado, Escuela Superior de Medicina del Instituto Politécnico Nacional, México DF, Mexico.
authors.forename: Juan
authors.initials: J
authors.lastname: Asbun-Bojalil
mesh_terms: D060433:Administration, Ophthalmic; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000601:surgery*; D015232:Dinoprostone / Q000037:antagonists & inhibitors / Q000096:biosynthesis; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000008:administration & dosage / Q000627:therapeutic use*; D008028:Light Coagulation / Q000009:adverse effects*; D008266:Macula Lutea / Q000648:ultrastructure; D008269:Macular Edema / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000187:drug effects; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012173:Retinitis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015232:Dinoprostone; D020910:Ketorolac
keywords: agudeza visual mejor corregida; best corrected visual acuity; edema macular; fotocoagulación; ketorolaco tópico; macular edema; photocoagulation; topical ketorolac