Topical Ketorolac and Steroids for Cataract Surgery

American Journal of Ophthalmology October

Wittpenn et al. evaluated whether adding perioperative topical ketorolac tromethamine 0.4 percent improves cataract surgery outcomes relative to topical steroids in patients without known risk factors for cystoid macular edema. In this clinical trial, patients scheduled to undergo phacoemulsification surgery were randomized to receive either prednisolone acetate 1 percent or prednisolone 1 percent plus ketorolac 0.4 percent four times daily for four weeks postoperatively. In the ketorolac-steroid group, patients also received topical ketorolac 0.4 percent four times a day for three days preoperatively. In both groups, patients received four doses of ketorolac 0.4 percent one hour before surgery. Outcome measures included CME incidence, retinal thickness as measured by OCT, BCVA and contrast sensitivity.
No patients in the ketorolac-steroid group had clinically apparent CME, compared with five patients in the steroid group. No ketorolac-steroid patient had definite or probable CME, compared with six steroid patients. Mean retinal thickening was less in the ketorolac-steroid group, and fewer had retinal thickening of more than 10 µm