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L.J. Kugler, M.V. Brumm, G.R. Christensen, J.L. Meza, E. Margalit; Safety of Intraocular Ketorolac . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1460.
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Purpose: Many retina specialists are injecting triamcinolone into the vitreous to treat diseases such as cystoid macular edema, diabetic macular edema, uveitis, and even age related macular degeneration. Common side effects of this treatment include cataract development and high intraocular pressure. Another alternative to treat such diseases could be intraocular nonsteroidal anti–inflammatory drugs (NSAIDs). Topical NSAIDs are known to be less cataractogenic, and not cause intraocular pressure elevation. Thus, we tried to determine whether ketorolac trometamol, an NSAID, is non–toxic to the retina when injected into the vitreous of rabbits. Methods: One tenth of a milliliter of preservative–free ketorolac trometamol was injected into the vitreous of the right eye of 15 Dutch–belted rabbits. Eight rabbits were injected with 0.5% ketorolac and seven rabbits were injected with 0.25% ketorolac. One tenth of a milliliter of balanced saline solution (BSS) was injected into the left eye of each rabbit as a control. A standard electroretinogram was obtained prior to injection, and repeated one day, one week, two weeks, three weeks, and four weeks after injection. After four weeks the rabbits were euthanized and the eyes enucleated for histopathologic examination by light and electron microscopy. Differences in the electroretinograms and histopathology between the two eyes were compared. Results: There were no statistically significant differences in electroretinograms obtained between the ketorolac eyes and the control eyes. No histopathological changes were observed in the study eyes compared to the control eyes. Conclusions: Ketorolac trometamol is non–toxic to the retina of rabbits when injected intravitreally, and could be examined as an alternative to intraocular steroid injections.
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