Objective
To evaluate the effects of topical ketorolac in patients undergoing vitreoretinal surgery.
Methods
One hundred nine patients undergoing vitrectomies were randomized to receive either topical ketorolac tromethamine, 0.4%, or placebo. Patients were instructed to begin taking the study medication 3 days preoperatively (4 times daily) and to continue taking it 4 weeks postoperatively.
Main Outcome Measures
Intraoperative pupil diameter, postoperative day 1 pain and inflammation, 1-month postoperative retinal thickness, and preoperative and 1-month postoperative best-corrected visual acuities.
Results
The difference in mean pupil diameters between patients using ketorolac and those taking placebo was 0.06 mm (P = .39). Patients taking ketorolac and those taking placebo had mean pain scores (scale, 1-10) of 0.24 (SD, 0.6) and 1.06 (SD, 2) (P = .03) and mean inflammation grades (grade, 0-4) of 0.59 (SD, 0.7) and 1.16 (SD, 0.9) (P < .001), respectively. Ketorolac reduced central subfield thickness by 8%, but this was not statistically significant. At 1 month, mean visual acuities improved to 0.40 logMAR units (mean Snellen, 20/50; SD, 0.28 logMAR units) in the ketorolac group from 0.83 logMAR units (20/150+2; SD, 0.60 logMAR units) at baseline and to 0.67 logMAR units (20/100+1; SD, 0.46 logMAR units) in the placebo group from 0.92 logMAR units (20/150−2; SD, 0.62 logMAR units) at baseline (P = .001).
Conclusions
Topical ketorolac was well tolerated and safe, reduced postoperative pain and inflammation, and improved visual recovery in this prospective, double-masked trial.
Application to Clinical Practice
Topical ketorolac may benefit patients undergoing vitreoretinal surgery.
Trial Registration
clinicaltrials.gov Identifier: NCT00576329