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H.D. Perry, P.J. Maris, Jr., E.D. Donnenfeld, T. Chou; Anesthesia and Ocular Tolerability of Topical Non–Steroidal Anti–Inflammatory Drugs: A Direct Comparison Between Ketorolac and Nepafenac . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4995. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the immediate and short–term anesthetic properties as well as the ocular tolerability of two commercially–available topical non–steroidal anti–inflammatory drugs (NSAIDs), ketorolac tromethamine 0.4% ophthalmic solution (Acular LS, Allergan, Inc.) and nepafenac 0.1% ophthalmic suspension (Nevanac, Alcon Laboratories).
20 subjects were administered one drop of ketorolac tromethamine 0.4% (KTT) ophthalmic solution in one eye and one drop of nepafenac 0.1% (NF) ophthalmic suspension in the fellow eye. Cochet–Bonnet esthesiometry of the central cornea was determined in each eye at baseline, then at 1–minute, 5–minutes, 10–minutes and 15–minutes following drop administration. Subjects also reported the subjective sensations of burning and stickiness on a scale of 0 – 10 in each eye immediately after drop administration. Inclusion criteria included the absence of active ocular surface pathology at the time of enrollment and a baseline esthesiometry measurement of 6.0. Data were analyzed by Mann–Whitney U testing. A p–value of < 0.05 was considered statistically significant for all analyses.
The mean ± standard deviation (SD) age among subjects was 35.2 ± 10.1 years. Mean ± SD esthesiometry measurements in the KTT group and NF groups respectively were: 5.8 ± 0.3 and 6.0 ± 0.0 at 1–minute post–dropping; 5.9 ± 0.1 and 6.0 ± 0.1 at 5–minutes; 6.0 ± 0.2 and 6.0 ± 0.0 at 10–minutes; and 6.0 ± 0.2 at 15–minutes. The variations in esthesiometry scores showed slightly more anesthetic effect in the KTT group at 1 and 5 minutes, but this was not statistically significant. The mean ± SD burning score was statistically significantly higher in the KTT group compared to the NF group: 1.6 ± 1.9 versus 0.4 ± 0.8. The mean ± SD stickiness score was statistically significantly higher in the NF group compared to the KTT group: 1.8 ± 1.6 versus 0.4 ± 0.8.
When KTT and NF were compared directly, the immediate and short–term anesthetic actions slightly favored the KTT group but not to a statistically significant level. KTT produced greater subjective burning when compared to NF. NF produced greater subjective stickiness when compared to KTT.
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