Katsev DA, et al. - The intracameral concentration of ketorolac tromethamine (ketorolac) was comprehensively investigated in this trial, at the beginning and end of cataract surgery following preoperative topical administration. The data displayed good at-home compliance with topical ketorolac, with 92.9% of patients using it as directed. Low levels of ketorolac were found in the aqueous humor, and 66.7% of patients reported undetectable levels, following cataract extraction and lens replacement.

Methods

• This research was carried out at Santa Barbara Surgery Center, Santa Barbara, CA, USA.
• The plot of this trial was a pre-post, interventional, single-arm study.
• Patients undergoing cataract extraction and lens replacement (CELR) were enrolled for this study.
• Written informed consent was obtained from 14 patients who were prescribed topical ophthalmic ketorolac based on the surgeon’s usual practice beginning the day prior to surgery.
• The surgeon withdrew 100 μL of aqueous humor from the operative eye immediately before the initial surgical incision and again just prior to final anterior chamber reinflation and wound closure.
• An estimation was performed of the ketorolac concentrations in the intracameral fluid samples.

Results

• Among 14 patients, 13 used four doses of ketorolac the day prior to surgery as directed, and one patient used three doses.
• It was reported that all 14 patients administered one drop of topical ketorolac on awakening and one drop after arriving at the surgery center, on the day of surgery.
• The range of preoperative ketorolac concentrations was estimated as 4.9 to 369 ng/mL, for the 12 patients from whom samples were collected.
• The range for end-of-procedure sample concentrations was estimated as <1.0 (the lower limit of quantification [LLOQ]) to 6.32 ng/mL, with 8 out of 12 patients exhibiting ketorolac levels below the LLOQ.