Ketorolac plus tobramycin/dexamethasone versus tobramycin/dexamethasone after uneventful phacoemulsification surgery: a randomized controlled trial.

To evaluate the benefit of adding a nonsteroid agent to an antibiotic/steroid combination after uneventful phacoemulsification, adopting a weekly follow-up, to gain insight into the optimal duration of postoperative treatment and to examine whether risk factors for inflammation exist.
Patients were randomized to (i) tobramycin 0.3%-dexamethasone 0.1%, 1 drop q.i.d. (n = 72), and (ii) a combination of tobramycin 0.3%-dexamethasone 0.1%, 1 drop q.i.d., plus ketorolac tromethamine 0.5%, 1 drop t.i.d. (n = 73). On days 7, 14, 21 and 28, the frequency of inflammation-related signs (corneal edema, conjunctival hyperemia, anterior chamber or Tyndall reaction) as well as best-corrected visual acuity (BCVA) were measured. On day 21, logistic regression was performed to evaluate risk factors for inflammation.
The frequency of inflammation-related signs did not differ between the 2 groups at any time point, neither did BCVA. On day 21, pseudoexfoliation was associated with the presence of any inflammation-related sign (OR = 4.5; 95% CI: 1.2-16.0; p = 0.022). No evidence of clinically significant cystoid macular edema became evident in either group.
The addition of ketorolac did not seem to offer any additional benefit in terms of inflammation-related signs. Four weeks appeared as an adequate treatment interval. Special attention should be paid to patients with pseudoexfoliation.
AuthorsIrini P Chatziralli, Leonidas Papazisis, Theodoros N Sergentanis
JournalOphthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift für Augenheilkunde (Ophthalmologica) Vol. 225 Issue 2 Pg. 89-94 ( 2011) ISSN: 1423-0267 [Electronic] Switzerland
PMID20881443 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
CopyrightCopyright © 2010 S. Karger AG, Basel.
Chemical References
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Glucocorticoids
  • Dexamethasone
  • Tobramycin
  • Ketorolac
  • Aged
  • Anti-Bacterial Agents (administration & dosage)
  • Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
  • Corneal Edema (diagnosis, prevention & control)
  • Dexamethasone (administration & dosage)
  • Drug Therapy, Combination
  • Eye Infections, Bacterial (diagnosis, prevention & control)
  • Female
  • Follow-Up Studies
  • Glucocorticoids (administration & dosage)
  • Humans
  • Keratitis (diagnosis, prevention & control)
  • Ketorolac (administration & dosage)
  • Male
  • Phacoemulsification
  • Postoperative Care
  • Postoperative Complications (prevention & control)
  • Risk Factors
  • Tobramycin (administration & dosage)
  • Treatment Outcome
  • Visual Acuity

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