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Randomized Controlled Trial
. 2008 Jan;34(1):64-9.
doi: 10.1016/j.jcrs.2007.08.034.

Effect of prophylactic nonsteroidal antiinflammatory drugs on cystoid macular edema assessed using optical coherence tomography quantification of total macular volume after cataract surgery

David R P Almeida  1 , Davin Johnson, Hussein Hollands, Donald Smallman, Stephanie Baxter, Kenneth T Eng, Vladimir Kratky, Martin W ten Hove, Sanjay Sharma, Sherif El-Defrawy
Affiliations
Randomized Controlled Trial

Effect of prophylactic nonsteroidal antiinflammatory drugs on cystoid macular edema assessed using optical coherence tomography quantification of total macular volume after cataract surgery

David R P Almeida et al. J Cataract Refract Surg. 2008 Jan.

Abstract

Purpose: To evaluate the efficacy of prophylactic administration of the topical nonsteroidal antiinflammatory drug (NSAID) ketorolac tromethamine 0.5% on acute (within 4 weeks of surgery) cystoid macular edema (CME) and total macular volume (TMV) in patients having phacoemulsification cataract surgery.

Setting: Department of Ophthalmology, Queen's University, Hotel Dieu Hospital, Kingston, Ontario, Canada.

Methods: This open-label nonmasked randomized (random number assignment) study comprised 106 eyes of 98 patients. Exclusion criteria included hypersensitivity to the NSAID drug class, aspirin/NSAID-induced asthma, and pregnancy in the third trimester. Ketorolac tromethamine 0.5% was administered starting 2 days before surgery and for 29 days after surgery for a total of 31 days. The outcome measure was macular swelling, which was quantified by the optical coherence tomography.

Results: At 1 month, there was a statistically significant difference in TMV between the control group (0.4420 mm3) and the ketorolac group (0.2392 mm3), with the ketorolac group having 45.8% less macular swelling (P = .009). Multiple linear regression with backward selection indicated a 44.3% (P = .013) and 46.1% (P = .030) reduction in macular swelling in the ketorolac group at 1 week and 1 month, respectively.

Conclusion: Used prophylactically after cataract surgery, ketorolac 0.5% was efficacious in decreasing postoperative macular edema.

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