Analgesic efficacy and safety of nonpreserved ketorolac tromethamine ophthalmic solution following radial keratotomy. Ketorolac Radial Keratotomy Study Group

Am J Ophthalmol. 1998 Apr;125(4):472-80. doi: 10.1016/s0002-9394(99)80187-1.

Abstract

Purpose: To compare the analgesic efficacy and safety of nonpreserved ketorolac tromethamine 0.5% with those of its vehicle in the treatment of postsurgical ocular pain following radial keratotomy.

Methods: This study employed a multicenter, double-masked, randomized, parallel-group design. Radial keratotomy patients were treated with either nonpreserved ketorolac tromethamine 0.5% or its vehicle four times daily for up to 3 days following surgery. Patients were provided with an escape medication (acetaminophen) for use only as needed for intolerable pain.

Results: Patients treated with ketorolac reported significantly greater pain relief (P < or =.023), less pain intensity (P < or =.047), less use of escape medication (P < or =.001), fewer symptoms of ocular discomfort (P=.024), and fewer sleep disturbances (P < or =.013) than did patients treated with vehicle. No treatment-related adverse events were reported in the ketorolac group, and only one treatment-related adverse event was reported in the vehicle group. Most other safety findings were equivalent in the two treatment groups except that there were significantly less eyelid erythema (P=.026) and eyelid edema (P < or =.001) in the ketorolac group.

Conclusions: Nonpreserved ketorolac tromethamine 0.5% ophthalmic solution was significantly more effective than, and as safe as, vehicle in the treatment of postoperative pain associated with radial keratotomy. Therefore, topical ketorolac may be a valuable treatment option for the maintenance of patient comfort following refractive surgery.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesia / methods*
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Cornea / surgery
  • Double-Blind Method
  • Female
  • Humans
  • Keratotomy, Radial / adverse effects*
  • Ketorolac Tromethamine
  • Male
  • Middle Aged
  • Myopia / surgery
  • Ophthalmic Solutions
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / etiology
  • Preservatives, Pharmaceutical
  • Safety
  • Tolmetin / administration & dosage
  • Tolmetin / adverse effects
  • Tolmetin / analogs & derivatives*
  • Tolmetin / therapeutic use
  • Treatment Outcome
  • Tromethamine / administration & dosage
  • Tromethamine / adverse effects
  • Tromethamine / analogs & derivatives*
  • Tromethamine / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Ophthalmic Solutions
  • Preservatives, Pharmaceutical
  • Tromethamine
  • Ketorolac Tromethamine
  • Tolmetin