May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Aqueous Penetration of Ketorolac 0.4% Compared With Bromfenac 0.09% in Cataract Patients: Peak and Trough Drug Concentrations
Author Affiliations & Notes
  • L. M. Amico
    Bucci Laser Vision Institute, Wilkes Barre, Pennsylvania
  • F. A. Bucci, Jr.
    Bucci Laser Vision Institute, Wilkes Barre, Pennsylvania
  • L. D. Waterbury
    Consultant, Irvine, California
  • Footnotes
    Commercial Relationships L.M. Amico, Allergan Inc., R; F.A. Bucci, Allergan Inc., R; L.D. Waterbury, None.
  • Footnotes
    Support None.
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 3929. doi:
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      L. M. Amico, F. A. Bucci, Jr., L. D. Waterbury; Aqueous Penetration of Ketorolac 0.4% Compared With Bromfenac 0.09% in Cataract Patients: Peak and Trough Drug Concentrations. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3929.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To compare the aqueous penetration of ketorolac tromethamine 0.4% (Acular LS) and bromfenac 0.09% (Xibrom) at peak and trough time points in patients scheduled for phacoemulsification.

Methods:: Sixty two phacoemulsification patients were randomized to receive ketorolac 0.4% (n=30) or bromfenac 0.09% (n=32). On label dosing of ketorolac 0.4% QID and bromfenac 0.09% BID was given 3 days prior to surgery. On the day of surgery each patient received 4 additional doses 90 minutes prior to surgery. Thirty two additional patients were randomized and analyzed (ketorolac 0.4%, n=16/bromfenac 0.09%, n=16) for on label trough drug levels. Aqueous samples were collected on label 12 hours after a single dose of bromfenac and 6 hours after a single dose of ketorolac. Trough patients received no pulse dosing prior to surgery. Following collection of 0.15cc of aqueous trough with a 30 gage needle through peripheral clear cornea, samples were stored at T-60°C prior to analysis. Drug concentrations were analyzed by liquid chromatography tandem mass spectrometry using positive turbo-ionspray ionization and multiple reaction monitoring mode for quantification.

Results:: Aqueous concentrations were significantly higher for ketorolac than bromfenac at both the peak and trough drug effect. At peak, mean concentrations were 772.5 ± 537.0 ng/mL for ketorolac and 39.5 ± 32.4 ng/mL for bromfenac (P<.001). At trough, mean concentrations were 130.5 ± 159.4 ng/mL for ketorolac and 6.2 ± 3.1 ng/mL for bromfenac (P=.004).

Conclusions:: In cataract patients just prior to phacoemulsification, ketorolac achieved significantly greater concentrations in the aqueous than did bromfenac at both peak and trough.

Clinical Trial:: www.clinicaltrials.gov NCT00347503

Keywords: inflammation • cataract • anterior chamber 
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