Comparison of the efficacy and safety of ketorolac tromethamine 0.5% and prednisolone acetate 1% after cataract surgery

Purpose: To compare the anti-inflammatory and analgesic efficacy and safety of ketorolac thromethamine 0.5% ophthalmic solution with those of predniso lone acetate 1% in patients having cataract surgery. Setting: Shawnee Mission Eye Care, Shawnee Mission, Kansas, USA. Methods: This double-blind, randomized, single-site study comprised 59 heal thy men and women with a clinical diagnosis of routine ocular cataract requ iring surgical removal. All patients had extracapsular cataract extraction and posterior chamber Intraocular lens implantation. After surgery, patient s were randomized to receive ketorolac tromethamine 0.5% or prednisolone ac etate 1%, self-instilled in the treated eye, according to the following sch edule: 1 to 2 drops 4 times daily (week 1); 3 times daily (week 2); 2 times daily (week 3); once daily (week 4). Patients were examined postoperativel y on days 1, 7, and 28. Intraocular anti-inflammatory efficacy was assessed by lid edema, lid injection, conjunctival injection, corneal edema, ciliar y flush, and anterior chamber cells. Analgesic efficacy was assessed by pat ient self-rated pain severity, pain frequency, total symptom sum, and overa ll global improvement. Results: Both treatments produced comparable reductions in intraocular infl ammation and pain after cataract surgery and were well tolerated by patient s. No adverse events were reported, and there were no significant changes i n intraocular pressure in either group. Improvements in visual acuity were also similar in both groups. Conclusion: Ketorolac tromethamine 0.5% ophthalmic solution was as effectiv e and well-tolerated as prednisolone acetate 1% solution in controlling pos toperative inflammation and pain after cataract surgery. (C) 1999 ASCRS and and ESCRS.