Purpose: The aim of this study was to determine if the concomitant use of ketorolac 0.4%
and cyclosporin-A improves patient comfort during the induction phase in treating chronic
dry eye disease.
Methods: Patients (n = 52) with clinically diagnosed dry eye were randomized to receive
either cyclosporin-A monotherapy twice-daily (BID) or a BID adjunctive regimen of ketorolac,
followed by the instillation of cyclosporin-A 10 min later. Study visits were at baseline,
week 2, and week 6. At each study visit, patients underwent an evaluation for corneal staining,
Schirmer's scores, and tear break-up time tests. Patients were asked to rate ocular comfort
on a 4-point scale and to complete the ocular surface disease index (OSDI©). Changes
from baseline readings were recorded at week-2 and week-6 visits, and final patient success
on treatment regimen was evaluated at week 6.
Results: After 6 weeks, the mean ocular comfort score of adjunctive patients improved 2.55 ±
0.95 points, versus 1.53 ± 0.91 points for monotherapy (P = 0.309). The adjunctive regimen
provided significantly greater corneal staining reductions versus monotherapy, mean reduction
in staining of 1.74 ± 0.9, versus 1.27 ± 0.56 (P = 0.044).
Conclusions: Concurrent ketorolac 0.4% use with cyclosporin-A significantly reduced
corneal staining and increased comfort in the induction phase.
