May 2007
Volume 48, Issue 13
ARVO Annual Meeting Abstract  |   May 2007
A Randomized, Double-Masked, Contralateral Eye Clinical Evaluation of Ketorolac 0.4% versus Nepafenac 0.1% in PRK Patients
Author Affiliations & Notes
  • S. Tauber
    Ophthalmology Research, St Johns Hospital and Clinic, Springfield, Missouri
  • W. Trattler
    The Center For Excellence in Eye Care, Miami, Florida
  • J. Luchs
    South Shore Eye Care, Wantagh, New York
  • P. Majmudar
    Chicago Cornea Consultants, Hoffman Estates, Illinois
  • Footnotes
    Commercial Relationships S. Tauber, None; W. Trattler, None; J. Luchs, None; P. Majmudar, None.
  • Footnotes
    Support Funded by unrestricted grants
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 5350. doi:
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      S. Tauber, W. Trattler, J. Luchs, P. Majmudar; A Randomized, Double-Masked, Contralateral Eye Clinical Evaluation of Ketorolac 0.4% versus Nepafenac 0.1% in PRK Patients. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5350.

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

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Purpose:: To compare efficacy and tolerability outcomes of ketorolac 0.4% and nepafenac 0.1% in patients undergoing photorefractive keratectomy (PRK).

Methods:: Randomized, double-masked, contralateral eye study. Patients (n = 32) underwent PRK, received bandage contact lenses (BCLs), and were randomized to ketorolac in one eye and nepafenac in the other for 4-5 days. Drops were instilled in patients before or after the BCL application, but in most patients (78%) drops were instilled after the BCL was applied. Patients rated their symptoms and pain immediately postoperatively, at 2 hours, 6 hours, and daily until the epithelium healed. Corneal haze was evaluated at week 2 and months 1, 2, and 3. Healing was evaluated on the day the BCL was removed.

Results:: Patients at Day 4 (17 of 20, 85%) rated their ketorolac-treated eye as "better" than their nepafenac-treated eye; at Day 5, of the 18 patients that completed the questionnaire, 91% (10 of 11) reported that their ketorolac-treated eye was "better." No between-group differences in symptoms were reported. Nepafenac-treated eyes displayed significantly more haze at week 2 (P = .026), month 1 (P = .014), and month 2 (P = .019) than did ketorolac-treated eyes. At week 2, 6 nepafenac-treated eyes had haze rated as 1+ and 1 was rated as trace, compared with only 2 ketorolac-treated eyes that exhibited trace haze. Ketorolac-treated eyes healed faster (4.7 days vs. 5.1 days with nepafenac), but this difference was not statistically significant (P = .137).

Conclusions:: These findings suggest that ketorolac 0.4% may provide superior outcomes after PRK than nepafenac 0.1% in terms of patient comfort, level of haze and rate of re-epitheliazation. These findings also support other studies that have demonstrated that nepafenac should be used cautiously following surface ablation procedures.

Clinical Trial:: NCT00405028

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials 

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