Preoperative ketorolac tromethamine 0.4% in phacoemulsification outcomes: Pharmacokinetic-response curve

Abstract

The preoperative use of ketorolac tromethamine 0.4% for 3 days followed by 1-day of predosing provided optimum efficacy and superior outcomes relative to 1-hour pretreatment and a placebo.

Ketorolac therapy for the prevention of acute pseudophakic cystoid macular edema: a systematic review

“…The Almeida, Donnenfeld, and Wittpenn studies were determined to have a statistical power of 2.5%, 45.1%, and 53.1%, respectively. 9,10,12 The power of the Chatiziralli study 11 was inestimable because of the fact that there were no incidents of CME in either group.…”

“…9,10 This compromise of objectivity raises concerns when interpreting these trials. As shown in a review of 370 RCTs, studies funded by for-profit organizations were 5.3 times more likely (95% CI, 2.0-14.4) than non-profit organizations to recommend the experimental drug as the treatment of choice.…”

“…One study used three disparate dosing regimens of ketorolac. 10 Two of the four studies were double-blinded. Duration of follow-up ranged from 4 to 13 weeks.…”

“…8 More specifically, several randomized controlled clinical trials (RCTs) have revealed the potential benefit of one of these topical NSAIDs, ketorolac tromethamine (Acular LS, Allergan Inc., Irvine, CA, USA), in the management of acute pseudophakic CME. [9][10][11][12] The purpose of this systematic review is to assess the effectiveness of ketorolac vs control in the treatment of acute pseudophakic CME (necessitating therapeutic intervention within 4 months of CME onset). [13][14][15] …”

Ocular Penetration and Anti-inflammatory Activity of Ketorolac 0.45% and Bromfenac 0.09% Against Lipopolysaccharide-Induced Inflammation

“…2,16 Topical NSAIDs typically are administered preoperatively and are continued postoperatively for several weeks. 11,17,18 Several studies have demonstrated that the addition of topical NSAIDs to a perioperative regimen of topical corticosteroids leads to less patient discomfort, reduced postoperative inflammation, prevention of miosis, and improvements in visual acuity in the early postoperative period relative to patients treated with topical steroids alone. 2,18,19 As ophthalmic formulations evolve and less frequent dosing is required (ie, from 4-times-daily to twice-daily), it is critical to understand maximal drug levels achieved and whether there is sufficient medication present at the end of a dosing cycle just before the next drop instillation that can still have a meaningful clinical effect.…”