Comparison of prednisolone 1%, rimexolone 1% and ketorolac tromethamine 0.5% after cataract extraction: a prospective, randomized, double-masked study. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie. [Graefes Arch Clin Exp Ophthalmol] Journal article | | Title | Comparison of prednisolone 1%, rimexolone 1% and ketorolac tromethamine 0.5% after cataract extraction: a prospective, randomized, double-masked study. | | Author(s) | Hirneiss C, Neubauer AS, Kampik A, Schönfeld CL | | Institution | Department of Ophthalmology, Ludwig Maximilians University, Mathildenstrasse 8, 80336 Munich, Germany. Christoph.Hirneiss@med.uni-muenchen.de | | Source | Graefes Arch Clin Exp Ophthalmol 2005 Aug; 243(8):768-73. | | MeSH | Administration, Topical
Aged
Anti-Inflammatory Agents, Non-Steroidal
Comparative Study
Double-Blind Method
Female
Glucocorticoids
Humans
Intraocular Pressure
Ketorolac Tromethamine
Lens Implantation, Intraocular
Male
Ophthalmic Solutions
Patient Satisfaction
Phacoemulsification
Postoperative Care
Prednisolone
Pregnadienes
Prospective Studies
Treatment Outcome
Uveitis, Anterior
| | Abstract | PURPOSE: To compare the efficacy, safety and patient comfort of two topical steroids (prednisolone 1% and rimexolone 1%) and a topical non-steroidal anti-inflammatory agent (ketorolac tromethamine 0.5%) after extracapsular cataract extraction.
METHODS: Forty-five patients were enrolled in this prospective, randomized, double-blind study. They were assigned to receive topical treatment with either prednisolone, rimexolone or ketorolac tromethamine ophthalmic solution after phacoemulsification for cataract extraction. On postoperative days 1, 3, 5, 14 and 28 best-corrected visual acuity, intraocular pressure (IOP), slit-lamp examination of the anterior segment and report of the patients' comfort were assessed and compared by Friedman rank time analysis.
RESULTS: Regarding the primary outcome efficacy of inflammation control the assessment of cells did not differ (p=0.165), while flare in the anterior chamber was lowest (p=0.008) in the non-steroidal anti-inflammatory drug (NSAID) group. Surface inflammation was lowest with prednisolone (p=0.002). Regarding safety, visual acuity did not differ among the groups. In the prednisolone group one patient, however, responded to steroid treatment with elevated IOP and had to be excluded. In the remaining patients IOP was even lower in the two steroidal treatment groups than with ketorolac (p=0.030). One patient receiving ketorolac had to be excluded because a corneal erosion developed. Patient comfort was highest with prednisolone (p=0.041).
CONCLUSIONS: Ketorolac tromethamine provides good control of intraocular inflammation after cataract extraction without the risk of a steroidal IOP increase, which was also not observed under rimexolone therapy. The best surface inflammation control and patient comfort was observed with prednisolone, which remains a good choice. | | Language | eng | | Pub Type(s) | Journal Article
Randomized Controlled Trial
| | PubMed ID | 15756571 |
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