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Abstract
This 6-week, partially masked, three-arm, multicenter study was conducted to evaluate
the postoperative anti-inflammatory efficacy of ketorolac, a cyclooxygenase inhibitor.
The study setting was the clinical practice of six ophthalmic surgeons. The study
enrolled 157 candidates for routine extracapsular cataract extraction or phacoemulsification
and posterior-chamber intraocular lens implantation. Patients who received any glucocorticoid
or cyclooxygenase inhibitor within 1 week of surgery were excluded. All patients were
treated with solutions of 0.5% ketorolac, 1% prednisolone acetate, or 0.1% dexamethasone
instilled into the operative eye three times daily from 1 day before surgery to 4
weeks after surgery. Efficacy variables included the signs of anterior-segment inflammation,
primarily cells and flare in the anterior chamber, as observed by slit-lamp biomicroscopy;
fluorescein leakage across the blood-aqueous barrier, as measured by fluorophotometry;
and the rating of efficacy by the investigator. No significant differences were seen
between ketorolac and either glucocorticoid in cells and flare. No significant differences
were found in other signs of inflammation, except conjunctival hyperemia and Descemet's
folds at week 2. Ketorolac showed significantly greater efficacy than the glucocorticoids
against blood-aqueous barrier breakdown at day 5 and week 2, as demonstrated by the
difference in fluorescein concentration between the operated and nonoperated eyes.
Investigators did not detect any significant difference in rating for overall effectiveness
and acceptability. These findings support the use of ketorolac as an alternative to
glucocorticoids for the treatment of postoperative inflammation.
Keywords
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© 1997 Published by Elsevier Inc.
