Purpose: The aim of this study was to compare the effectiveness and patient tolerance of
0.4% ketorolac tromethamine ophthalmic solution and 0.5% ketorolac tromethamine ophthalmic
solution after routine phacoemulsification and lens implantation.
Setting: The setting for this study was the Storm Eye Institute and Magill Research Center
for Vision Correction, Medical University of South Carolina (Charleston, SC).
Methods: This work was a prospective, double-masked study that included 40 eyes of 40
patients randomly assigned to receive topical treatment with 0.4% ketorolac or 0.5% ketorolac,
starting 15 min prior to routine phacoemulsification and foldable posterior chamber intraocular
lens implantation. Following the procedure, patients were instructed to use the assigned
treatment agent 4 times a day after surgery for 1 week and twice a day for 3 weeks,
when drops were discontinued. Slit-lamp examination, intraocular pressure (IOP), laser cell
and flare measurements, and subjective patient tolerance were evaluated postoperatively at
1, 7, and 30 d. Comparisons between the 2 groups were made at each visit, as well as comparisons
to baseline. A P = value less than .05 was considered statistically significant.
Results: At day 1, a higher percentage of patients (70% vs. 40%) reported symptoms (mainly
foreign body sensation and stinging/burning) in the 0.5% ketorolac group, compared to the
0.4% ketorolac group. No significant differences were found between the 2 groups over time
regarding best-corrected visual acuity (BCVA), IOP, slit-lamp assessment of cells, and cell and
flare measured using the laser cell/flare meter.
Conclusions: Treatment with 0.4% ketorolac tromethamine ophthalmic solution is as effective
as 0.5% ketorolac tromethamine ophthalmic solution in reducing inflammation after routine
cataract surgery. Patients reported less discomfort using 0.4% ketorolac.
