Study: Ketorolac shows good short-term efficacy for vitrectomy patients

Topical ketorolac appears promising for reducing postoperative pain and inflammation and improving visual recovery after vitreoretinal surgery, a prospective study suggests.

Stephen J. Kim, MD, and colleagues evaluated the effect of ketorolac tromethamine 0.4% on postoperative pain, inflammation, visual acuity and pupil diameter among 109 eyes of 109 patients after uncomplicated vitrectomy. Specifically, 55 patients were randomly assigned to receive ketorolac and 54 controls received placebo. Patients began taking medication in four daily intervals 3 days before surgery and were instructed to maintain the regimen for 1 month postop.

At baseline, visual acuity averaged 0.83 logMAR in the ketorolac group and 0.92 logMAR in the control group.

At 1-month postop, the investigators found that there was 0.06 mm difference in average pupil diameter between patients in the ketorolac and placebo groups (P = .39).

Pain scores, which were based on a 10-point scale, averaged 0.24 in the ketorolac group, significantly less than 1.06 in the control group (P = .03), the authors noted.

Inflammation, which was graded on a scale from 0 to 4, averaged 0.59 in the ketorolac group, also significantly less than 1.16 in the control group (P < .001).

Although ketorolac had reduced central subfield thickness by 8%, the change was not statistically significant.

At 1 month, average visual acuity had improved to 0.40 logMAR in the ketorolac group and to 0.67 logMAR in the placebo group (P = .001), according to the study, published in the September issue of Archives of Ophthalmology.