Effects of topical ketorolac tromethamine 0.45% on intraoperative miosis and prostaglandin E2 release during femtosecond laser–assisted cataract surgery

Abstract

To determine the effects of topical 0.45% ketorolac tromethamineon intraoperative miosis and prostaglandin E2 (PGE2) release during femtosecond laser-assisted cataract surgery. Seoul St. Mary's Hospital, Seoul, Korea. Prospective case series. The study comprised the following 3 groups: conventional cataract surgery without topical NSAIDs (conventional group); femtosecond laser-assisted cataract surgery with preoperative topical ketorolac tromethamine 0.45% (femtosecond NSAID group), and femtosecond laser-assisted cataract surgery without topical NSAIDs (femtosecond no-NSAID group). To measure the aqueous humor PGE2 concentration, a 100μL aqueous humor sample was collected from the anterior chamber after femtosecond laser pretreatment. The PGE2 concentration was measured using an enzyme immunoassay. Topical ketorolac tromethamine 0.45% led to a significant reduction in intraoperative miosis in the femtosecond NSAID group compared with the femtosecond no-NSAID group (P<.001). Absolute and relative reductions in pupil area in the femtosecond NSAID group were significantly lower than in the femtosecond no-NSAID group (P=.019 and P=.007, respectively). The mean aqueous humor PGE2 concentrations were 893.60 pg/mL ± 843.10 (SD) in the conventional group, 1911.43±1178.63 pg/mL in the femtosecond NSAID group, and 743.63±927.46 pg/mL in the femtosecond no-NSAID group (P<.001, conventional versus femtosecond NSAID and femtosecond NSAID versus femtosecond no NSAID; P>.05, conventional versus femtosecond NSAID). Preoperative topical ketorolac tromethamine 0.45% reduced miosis induced by femtosecond laser pretreatment and inhibitedaqueous humor PGE2 elevation.