Effects of topical ketorolac tromethamine 0.45% on intraoperative miosis and prostaglandin E release during femtosecond laser-assisted cataract surgery.

PURPOSE

To determine the effects of topical 0.45% ketorolac tromethamine on intraoperative miosis and prostaglandin E (PGE) release during femtosecond laser-assisted cataract surgery.

SETTING

Seoul St. Mary's Hospital, Seoul, Korea.

DESIGN

Prospective case series.

METHODS

The study comprised the following 3 groups: conventional cataract surgery without topical NSAIDs (conventional group); femtosecond laser-assisted cataract surgery with preoperative topical ketorolac tromethamine 0.45% (femtosecond NSAID group), and femtosecond laser-assisted cataract surgery without topical NSAIDs (femtosecond no-NSAID group). To measure the aqueous humor PGE concentration, a 100 μL aqueous humor sample was collected from the anterior chamber after femtosecond laser pretreatment. The PGE concentration was measured using an enzyme immunoassay.

RESULTS

Topical ketorolac tromethamine 0.45% led to a significant reduction in intraoperative miosis in the femtosecond NSAID group compared with the femtosecond no-NSAID group (P < .001). Absolute and relative reductions in pupil area in the femtosecond NSAID group were significantly lower than in the femtosecond no-NSAID group (P = .019 and P = .007, respectively). The mean aqueous humor PGE concentrations were 893.60 pg/mL ± 843.10 (SD) in the conventional group, 1911.43 ± 1178.63 pg/mL in the femtosecond NSAID group, and 743.63 ± 927.46 pg/mL in the femtosecond no-NSAID group (P < .001, conventional versus femtosecond NSAID and femtosecond NSAID versus femtosecond no NSAID; P > .05, conventional versus femtosecond NSAID).

CONCLUSION

Preoperative topical ketorolac tromethamine 0.45% reduced miosis induced by femtosecond laser pretreatment and inhibited aqueous humor PGE elevation.