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Efficacy and safety profile of ketorolac 0.5% ophthalmic solution in the prevention of surgically induced miosis during cataract surgery.

Abstract
This multicenter, double-masked, randomized, parallel study compared the efficacy and safety profile of ketorolac tromethamine 0.5% ophthalmic solution with that of its vehicle in the maintenance of pupillary mydriasis during cataract surgery. A total of 176 adult patients scheduled to undergo unilateral extracapsular cataract extraction and posterior-chamber intraocular lens implantation received either ketorolac tromethamine 0.5% (n = 89) or vehicle (n = 87), starting 2 hours before surgery. One drop of study medication was instilled every 30 minutes for a total of 4 drops. No epinephrine was used in the intraoperative irrigating solution. Pupil diameter was measured with a caliper at 3 time points during surgery. To ensure participant safety, biomicroscopy, ophthalmoscopy, intraocular pressure, adverse events, and preoperative and postoperative visual acuity and refractive error were also monitored. The mean change in horizontal and vertical pupil diameter from the time of the first incision to after cortical irrigation and aspiration was significantly less with active ketorolac than with vehicle (P < or = 0.014). Consequently, mean pupil diameter after cortical irrigation and aspiration was significantly greater with ketorolac than with vehicle (P < or = 0.030). No significant between-group differences were observed in the change in pupil diameter between the end of surgery and postoperative administration of a miotic agent, safety variables, or occurrence of adverse events. In this study, ketorolac tromethamine 0.5% ophthalmic solution provided effective and well-tolerated inhibition of surgically induced miosis during cataract surgery.
AuthorsR Stewart, R Grosserode, J K Cheetham, A Rosenthal
JournalClinical therapeutics (Clin Ther) Vol. 21 Issue 4 Pg. 723-32 (Apr 1999) ISSN: 0149-2918 [Print] United States
PMID10363737 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Ophthalmic Solutions
  • Tromethamine
  • Ketorolac Tromethamine
  • Tolmetin
Topics
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, therapeutic use)
  • Cataract Extraction
  • Double-Blind Method
  • Female
  • Humans
  • Ketorolac Tromethamine
  • Male
  • Middle Aged
  • Miosis (prevention & control)
  • Ophthalmic Solutions
  • Postoperative Complications (prevention & control)
  • Tolmetin (administration & dosage, analogs & derivatives, therapeutic use)
  • Tromethamine (administration & dosage, analogs & derivatives, therapeutic use)

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