NSAID may lower IOP after glaucoma valve implantation

Ophthalmic Surg Lasers Imaging. 2011;42(3):190-195.

An NSAID may aid in lowering postoperative IOP after implantation of a glaucoma drainage device, a study found.

The anti-inflammatory effects of Acular (ketorolac tromethamine ophthalmic solution 0.5%, Allergan) could reduce subconjunctival fibrosis surrounding the Ahmed glaucoma drainage device (New World Medical), decreasing the probability of a hypertensive phase, the study authors said.

The retrospective chart review analyzed 64 eyes of 62 patients; ketorolac tromethamine was used in 14 eyes. There were no significant differences between the two groups preoperatively, aside from racial disparities. Two Native Americans were included in the ketorolac tromethamine group, and five African Americans were among the other participants, a difference that the authors believe potentially affected study outcomes.

Average follow-up was 16 months. Mean preoperative IOP was similar between the two groups, but at 6 months postop, the ketorolac tromethamine group had a significantly lower IOP (13.1 ± 3.7 mm Hg vs. 19.5 ± 9.3 mm Hg; P = .0003). No difference was seen in the number of postop glaucoma medications between groups.

However, 72% of patients who did not receive ketorolac tromethamine developed a hypertensive phase, compared with only 50% of the contending group.