Aqueous prostaglandin E2 of cataract patients at trough ketorolac and bromfenac levels after 2 days dosing

Bucci, Frank A.; Waterbury, L. David

doi:10.1007/s12325-009-0042-5

Cited by 16 publications

(8 citation statements)

References 17 publications

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“…Compared to diclofenac, it has been shown to provide significantly higher concentrations in the aqueous humour and to remain in the anterior chamber for a longer duration [20], which is the probable explanation for the extended mydriasis during cataract surgery [21]. It has also been shown to cause a stronger inhibition of PG synthesis compared to bromfenac [20,21]. Ketorolac is widely used in our country, especially for the prophylaxis of aphakia and pseudophakic cystoid macular oedema, ocular inflammation and pain, postoperative inflammation and allergic ocular conditions [20].…”

Section: Discussionmentioning

confidence: 99%

Effect of Ketorolac Add-On Treatment on Intra-Ocular Pressure in Glaucoma Patients Receiving Prostaglandin Analogues

Vural¹,

Torun-Acar²,

Acar³

2011

Ophthalmologica

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Background/Aims: While topical ocular hypotensive agents cause secretion of endogenous prostaglandin (PG), systemic and topical non-steroidal anti-inflammatory agents inhibit its production; thus, they may interfere with therapeutic efficacy. This study aimed to investigate the effect of add-on treatment with ketorolac on intra-ocular pressure (IOP)-lowering effects of three different PG analogues. Methods: This study included 30 adult bilateral glaucoma patients who had been receiving PG analogues for primary open-angle glaucoma (n = 25) or pseudoexfoliation glaucoma (n = 5). Ketorolac tromethamine 0.5% and placebo drops were administered to the right and left eyes of the patients, respectively, 4 times a day for 1 week. IOP measurements were performed at baseline, within the first 4 h after application, on days 1, 3 and 7, and 1 and 7 days after discontinuation of the treatment. Results: Eyes receiving ketorolac had significantly lower IOP throughout the treatment period (p < 0.001). Patients who were on latanoprost, travoprost and bimatoprost did not differ with regard to the change in IOP (p = 0.780). After discontinuation, pressures became similar on day 1 (p = 0.796) and day 7 (p = 0.314). Conclusion: In glaucoma patients, ketorolac significantly enhances the IOP-lowering effects of latanoprost, travoprost and bimatoprost.

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Section: Discussionmentioning

confidence: 99%

Effect of Ketorolac Add-On Treatment on Intra-Ocular Pressure in Glaucoma Patients Receiving Prostaglandin Analogues

Vural¹,

Torun-Acar²,

Acar³

2011

Ophthalmologica

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“… 17 Concentrations achieved in this study are similar to those achieved at 6 h following intracameral administration. Topical dosing of ketorolac 0.40% at 6 h before surgery resulted in a considerably lower concentration of ketorolac in aqueous 18 compared with results achieved by intracameral dosing.…”

Section: Resultsmentioning

confidence: 84%

Alternative Drug Delivery for Patients Undergoing Cataract Surgery as Demonstrated in a Canine Model

Waterbury¹

2018

Journal of Ocular Pharmacology and Therapeutics

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Purpose: (1) To determine ketorolac concentrations in selected ocular tissues following the intracameral administration of phenylephrine and ketorolac injection 1%/0.3% (OMIDRIA®) delivered in irrigation solution during lens replacement surgery in beagle dogs. (2) To compare the ketorolac initial dose and resultant concentrations from the above study to those achieved in aqueous and vitreous by topical administration in patients undergoing cataract surgery or vitrectomy, respectively.Methods: Lens replacement surgery with phacoemulsification was performed in 20 female beagle dogs. A fixed combination of phenylephrine and ketorolac injection 1%/0.3% was diluted 125-fold into the balanced salt solution and delivered intracamerally during the phacoemulsification procedure. Ketorolac concentration was determined by liquid chromatography/mass spectrometry.Results: Concentrations of ketorolac when administered by the intracameral route in the dosing solution in dogs were found to be considerably higher in both aqueous and vitreous compared to what is achieved with topical dosing in patients.Conclusions: Adequate therapeutic concentrations of ketorolac in aqueous and vitreous humor were achieved even at 10 h postdose. Critical concentrations in the aqueous that envelopes the iris/ciliary body, which are sites of prostaglandin E2 synthesis, and the vitreous are not achieved by topical dosing in clinical studies after the surgery, but are by direct intracameral dosing as determined in this study. Based on these studies and clinical data, phenylephrine and ketorolac injection 1%/0.3% delivered during surgery as an irrigation solution may preclude the need for topically administered pre- and postoperative NSAIDs.

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“…El-Harazi et al [ 27 ] also reported that no significant difference was detected in inflammatory response between groups given ketorolac 30 minutes before and 1 day after surgery. Bucci and Waterbury [ 28 ] studied patients undergoing cataract surgery who received either ketorolac q.i.d. or bromfenac b.i.d.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Perioperative Topical Ketorolac 0.5% on Macular Thickness after Uneventful Phacoemulsification

Dal

Saraç

Toklu

et al. 2017

Journal of Ophthalmology

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Background To evaluate the effects of topical 0.5% ketorolac treatment combined with topical steroids on macular thickness in cases who had uneventful phacoemulsification surgery. Methods 58 eyes of 58 consecutive cases were included. The mean foveal thickness (MFT), parafoveal thickness (ParaFT), and perifoveal thickness (PeriFT) measurements were performed with optical coherence tomography (RTVue-100, Optovue, Fremont, CA, USA) preoperatively and at postoperative 1 week, 1 month, and 2 months. All cases received topical 0.1% dexamethasone postoperatively. Randomly selected cases additionally received topical 0.5% ketorolac, which started 2 days prior to surgery. Cases who received both topical steroids and ketorolac formed group 1 and subjects who received only topical steroids formed group 2. Results The increase in mean MFT at the 1st week, 1st month, and 2nd months after surgery in group 1 was significantly lower than group 2 (P = 0.008, P ≤ 0.001, and P ≤ 0.001, resp.). In group 1, the increase in mean ParaFT and PeriFT was significantly lower than group 2 at the 1st and 2nd months of the surgery (P < 0.05 for all variables). Conclusions Topical ketorolac combined with steroids is highly efficacious in order to prevent increment in thickness on each part of the macula even after an uneventful phacoemulsification surgery comparing to steroid monotheraphy.

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Aqueous prostaglandin E2 of cataract patients at trough ketorolac and bromfenac levels after 2 days dosing

Cited by 16 publications

References 17 publications

Effect of Ketorolac Add-On Treatment on Intra-Ocular Pressure in Glaucoma Patients Receiving Prostaglandin Analogues

Effect of Ketorolac Add-On Treatment on Intra-Ocular Pressure in Glaucoma Patients Receiving Prostaglandin Analogues

Alternative Drug Delivery for Patients Undergoing Cataract Surgery as Demonstrated in a Canine Model

The Effect of Perioperative Topical Ketorolac 0.5% on Macular Thickness after Uneventful Phacoemulsification

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