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Comparison of ketorolac 0.4% and nepafenac 0.1% for the prevention of cystoid macular oedema after phacoemulsification: prospective placebo-controlled randomised study
  1. Patrick Frensel Tzelikis1,
  2. Monike Vieira1,
  3. Wilson Takashi Hida1,2,
  4. Antonio Francisco Motta2,
  5. Celso Takashi Nakano2,
  6. Eliane Mayumi Nakano1,
  7. Milton Ruiz Alves2
  1. 1Brasilia Ophthalmologic Hospital, HOB, Brasilia, DF, Brazil
  2. 2Ophthalmology Department, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
  1. Correspondence to Dr Patrick F Tzelikis, Brasilia Ophthalmologic Hospital, HOB, SQN 203, bloco K, apart 502, Brasilia, DF 70833-110, Brazil; tzelikis{at}


Purpose To compare the anti-inflammatory efficacy of ketorolac of tromethamine 0.4% and nepafenac 0.1% eye drops for prophylaxis of cystoid macular oedema (CME) after small-incision cataract extraction.

Methods Patients were assigned randomly to three groups. Group 1 patients received a topical artificial tear substitute (placebo); group 2 received ketorolac tromethamine 0.4% (Acular LS, Allergan) and group 3 received nepafenac 0.1% (Nevanac, Alcon). The incidence and severity of CME were evaluated by retinal foveal thickness on optical coherence tomography (OCT) after 1, 4 and 12 weeks.

Results One hundred and twenty-six eyes of 126 patients were included in this study. The between-group differences in visual outcomes, central corneal thickness and endothelial cell density were not statistically significant. In all retinal thickness measurements, an increase was detected starting from the postoperative first week until 12 weeks. There was no statistically significant difference between the three groups in any measurement performed by spectral-domain OCT.

Conclusions Used prophylactically after uneventful cataract surgery, non-steroidal anti-inflammatory drugs were not efficacious in preventing macular oedema compared with placebo.

Trial registration number ClinicalTrials: NCT02084576.

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