Original articleEfficacy and Tolerability of Preservative-Free and Preserved Diclofenac and Preserved Ketorolac Eyedrops After Cataract Surgery
Section snippets
Methods
This prospective, randomized, investigator-masked, parallel-group, open-label, comparative, 4-week trial was conducted from July 2005 through February 2008 in an institutional setting at the Department of Ophthalmology and Optometry, Medical University of Vienna. One hundred two consecutive patients scheduled for phacoemulsification cataract surgery with implantation of a posterior chamber intraocular lens were enrolled in the study. Baseline patient characteristics are given in the Table.
Results
Of the 102 subjects enrolled and randomized, 34 eyes were assigned to each of the 3 treatment groups. Ninety-three patients, 31 of the preservative-free diclofenac group (91.2%), 29 of the preserved diclofenac group (85.3%), and 33 of the preserved ketorolac group (97.1%) completed the study (Figure 1). Seven patients were lost to follow-up (1 had urgent orthopedic surgery and 6 did not appear for follow-up and declined an additional visit despite contact by telephone), and 2 patients had to be
Discussion
Although all NSAIDs inhibit the cyclooxygenase pathway, diclofenac additionally inhibits the lipoxygenase pathway.5, 6, 18 This unique quality of diclofenac gives it a spectrum of activity more similar to corticosteroids and gives expectations for an increased anti-inflammatory efficacy. However, in an animal model of ocular inflammation, topical ketorolac exhibited greater anti-inflammatory effects than diclofenac and loteprednol.19 Several studies in human eyes have shown topical diclofenac
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