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R. N. Vianna, A. C. Afonso Reis, G. P. Cardoso; Intravitreal Ketorolac in Patients With Diabetic Macular Edema Refractory to Laser Photocoagulation: Short-Term Results. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5029.
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Experimental studies have recently demonstrated that intraocular ketorolac is nontoxic to the retina when injected intravitreally and could be considered as an alternative to intraocular steroid injections. The aim of this paper was to evaluate the short-term results of the treatment with intravitreal ketorolac in patients with diabetic macular edema refractory to laser photocoagulation.
Retrospective non-randomized case series. Nine patients (9 eyes) with diabetic macular edema refractory to laser photocoagulation received a single intravitreal injection of preservative-free ketorolac trometamine (500 µg / 0.1 ml). Examination included assessment of best corrected ETDRS visual acuity (BCVA), measurement of intraocular pressure, fluorescein angiography and high resolution imaging by optical coherence tomography (OCT 3), preoperatively, 1 week and 1 month postoperatively.
Within one month six eyes showed a one-or-more-line improvement in BCVA. Visual acuity remained stable (no change) in one eye and showed a decline in two eyes. There was a reduction of the macular thickness in six eyes.No systemic or ocular side effects were noted at any time.
The short-term results of this small pilot study are promising and suggest that intravitreal ketorolac may be considered as an alternative to steroids in patients with diabetic macular edema refractory to laser photocoagulation. Nevertheless, further studies with larger samples and longer follow-up are necessary to confirm the efficacy and safety of this treatment.
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