Topical ketorolac tromethamine 0.5% ophthalmic solution in ocular inflammation after cataract surgery

Purpose: To compare the efficacy and safety of ketorolac 0.5% ophthalmic solution with its vehicle in the treatment of ocular inflammation after cataract surgery and intraocular lens implantation. Design: Multicenter clinical study. Participants: One hundred four patients were prospectively randomized, 52 patients in treatment group, 52 patients in control group. Methods: Patients received either ketorolac or vehicle four times daily in the operated eye for 14 days starting the day after surgery in a prospective, double-masked, randomized, parallel group study. Only patients with moderate or greater postoperative inflammation the day after surgery were enrolled. Main Outcome Measures: The main outcome measures include inflammation (cell, flare, ciliary flush), intraocular pressure and visual acuity. Results: Ketorolac was significantly more effective than vehicle in reducing the manifestations of postoperative ocular inflammation, including: anterior chamber cells (P = 0.002) and flare (P = 0.009), conjunctival erythema (P = 0.010), ciliary flush (P = 0.022), photophobia (P = 0.027), and pain (P = 0.043). Five times as many patients were dropped from the study for lack of efficacy from the vehicle group (22/52) than from the ketorolac group (4/52; P = 0.001). Ketorolac was found to be equally as safe as vehicle in terms of adverse events, changes in visual acuity, intraocular pressure, and biomicroscopic and ophthalmoscopic variables. Conclusions: Ketorolac tromethamine 0.5% ophthalmic solution was significantly more effective than vehicle in the treatment of moderate or greater ocular inflammation following routine cataract surgery, while being as safe as vehicle. Ophthalmology 2001;108:331-337 (C) 2001 by the American Academy of Ophthalmology.