The Prophylactic Effect of Topical Ketorolac Tromethamine on Macular Thickening after Phacoemulsification in Diabetic Patients

Abstract Background: To determine the prophylactic effect of ketorolac tromethamine0.5% in preventing post-phacoemulsification macular thickening. This randomized clinical trial. patients randomized 1:1 to receive either topical ketorolac three times a day or a placebo. Methods: A total of 101 eyes of 101 diabetic patients who were scheduled for phacoemulsification and had normal macular contour and thickness enrolled consecutively. The topical ketorolac and placebo were prescribed on the day before surgery and continued up to 4 weeks after surgery. Patients with proliferative diabetic retinopathy, a history of intravitreal injection in less than three months, a history of macular photocoagulation in less than 6 months, and any other concomitant ocular pathologies were excluded. Central macular thickness (CMT) and best corrected visual acuity (BCVA) was recorded in the follow-ups of 6, 12, and 24 weeks after the surgery and compared with the controls. Results: 49 eyes in the case group and 52 eyes in the control group were analyzed.Mean BCVA was significantly improved in both groups at all follow-ups (P<0.001 for all). There was no statistically significant difference regarding the BCVA in different time points except week 12 (P=0.028) among the study group. In the case and control groups, CMT was increased at all follow-ups (P<0.05). There was no statistically significant difference when comparing the two groups regarding the mean of CMT at any time point postoperatively (P>0.05 for all). Conclusion: Based on our findings, topical ketorolac tromethamine 0.5% is not effective in the prevention of post-phacoemulsification macular thickening in diabetic patients. Trail registration: The study protocol was registered into www.clinicaltrial.gov with the RCT registration number NCT03551808. ( May 2018 )