Impaired corneal wound healing associated with ketorolac 0.5% after uncomplicated extracapsular cataract extraction

Mark L. Arey, Brian R. Sullivan, Carol G. Reinert, James P McCulley

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

PURPOSE: To describe an apparent association between the use of ketorolac 0.5% (Acular; Allergan) for cystoid macular edema (CME) prophylaxis and impaired corneal wound healing in patients undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation. METHODS: A retrospective case series reviewing 7 eyes of 7 patients who underwent uncomplicated ECCE with IOL implantation and were treated postoperatively with ketorolac 0.5% 4 times daily as a prophylactic measure against CME. RESULTS: Patients were treated with ketorolac 0.5% 4 times a day for an average of 30 days (range, 20-44 days) after uncomplicated ECCE with IOL implantation. Two eyes developed postoperative endophthalmitis necessitating vitreous tap with intravitreal antibiotic injection; 1 eye went on to require pars plana vitrectomy with corneal wound resuturing. One eye developed corneal wound dehiscence that required wound resuturing in the operating room. One eye developed an inadvertent filtering bleb despite the lack of postoperative suture lysis. Three others were followed up closely postoperatively with slit-lamp evidence of impaired wound healing, manifested by wound avascularity and/or wound gape, and did not require surgical intervention. CONCLUSIONS: The use of nonsteroidal anti-inflammatory agents for prophylaxis of CME after cataract surgery is an evolving trend. This retrospective case series showed a possible link between the use of ketorolac 0.5% and impaired corneal wound healing, and caution is urged in the liberal use of this agent postoperatively after ECCE.

Original languageEnglish (US)
Pages (from-to)1159-1164
Number of pages6
JournalCornea
Volume26
Issue number10
DOIs
StatePublished - Dec 2007

Fingerprint

Ketorolac
Cataract Extraction
Wound Healing
Intraocular Lens Implantation
Macular Edema
Wounds and Injuries
Ketorolac Tromethamine
Intravitreal Injections
Endophthalmitis
Temazepam
Vitrectomy
Non-Steroidal Anti-Inflammatory Agents
Operating Rooms
Blister
Cataract
Sutures
Anti-Bacterial Agents

Keywords

  • Cataract surgery
  • Ketorolac
  • NSAID
  • Wound healing

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Impaired corneal wound healing associated with ketorolac 0.5% after uncomplicated extracapsular cataract extraction. / Arey, Mark L.; Sullivan, Brian R.; Reinert, Carol G.; McCulley, James P.

In: Cornea, Vol. 26, No. 10, 12.2007, p. 1159-1164.

Research output: Contribution to journalArticle

Arey, Mark L. ; Sullivan, Brian R. ; Reinert, Carol G. ; McCulley, James P. / Impaired corneal wound healing associated with ketorolac 0.5% after uncomplicated extracapsular cataract extraction. In: Cornea. 2007 ; Vol. 26, No. 10. pp. 1159-1164.
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abstract = "PURPOSE: To describe an apparent association between the use of ketorolac 0.5{\%} (Acular; Allergan) for cystoid macular edema (CME) prophylaxis and impaired corneal wound healing in patients undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation. METHODS: A retrospective case series reviewing 7 eyes of 7 patients who underwent uncomplicated ECCE with IOL implantation and were treated postoperatively with ketorolac 0.5{\%} 4 times daily as a prophylactic measure against CME. RESULTS: Patients were treated with ketorolac 0.5{\%} 4 times a day for an average of 30 days (range, 20-44 days) after uncomplicated ECCE with IOL implantation. Two eyes developed postoperative endophthalmitis necessitating vitreous tap with intravitreal antibiotic injection; 1 eye went on to require pars plana vitrectomy with corneal wound resuturing. One eye developed corneal wound dehiscence that required wound resuturing in the operating room. One eye developed an inadvertent filtering bleb despite the lack of postoperative suture lysis. Three others were followed up closely postoperatively with slit-lamp evidence of impaired wound healing, manifested by wound avascularity and/or wound gape, and did not require surgical intervention. CONCLUSIONS: The use of nonsteroidal anti-inflammatory agents for prophylaxis of CME after cataract surgery is an evolving trend. This retrospective case series showed a possible link between the use of ketorolac 0.5{\%} and impaired corneal wound healing, and caution is urged in the liberal use of this agent postoperatively after ECCE.",
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N2 - PURPOSE: To describe an apparent association between the use of ketorolac 0.5% (Acular; Allergan) for cystoid macular edema (CME) prophylaxis and impaired corneal wound healing in patients undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation. METHODS: A retrospective case series reviewing 7 eyes of 7 patients who underwent uncomplicated ECCE with IOL implantation and were treated postoperatively with ketorolac 0.5% 4 times daily as a prophylactic measure against CME. RESULTS: Patients were treated with ketorolac 0.5% 4 times a day for an average of 30 days (range, 20-44 days) after uncomplicated ECCE with IOL implantation. Two eyes developed postoperative endophthalmitis necessitating vitreous tap with intravitreal antibiotic injection; 1 eye went on to require pars plana vitrectomy with corneal wound resuturing. One eye developed corneal wound dehiscence that required wound resuturing in the operating room. One eye developed an inadvertent filtering bleb despite the lack of postoperative suture lysis. Three others were followed up closely postoperatively with slit-lamp evidence of impaired wound healing, manifested by wound avascularity and/or wound gape, and did not require surgical intervention. CONCLUSIONS: The use of nonsteroidal anti-inflammatory agents for prophylaxis of CME after cataract surgery is an evolving trend. This retrospective case series showed a possible link between the use of ketorolac 0.5% and impaired corneal wound healing, and caution is urged in the liberal use of this agent postoperatively after ECCE.

AB - PURPOSE: To describe an apparent association between the use of ketorolac 0.5% (Acular; Allergan) for cystoid macular edema (CME) prophylaxis and impaired corneal wound healing in patients undergoing extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation. METHODS: A retrospective case series reviewing 7 eyes of 7 patients who underwent uncomplicated ECCE with IOL implantation and were treated postoperatively with ketorolac 0.5% 4 times daily as a prophylactic measure against CME. RESULTS: Patients were treated with ketorolac 0.5% 4 times a day for an average of 30 days (range, 20-44 days) after uncomplicated ECCE with IOL implantation. Two eyes developed postoperative endophthalmitis necessitating vitreous tap with intravitreal antibiotic injection; 1 eye went on to require pars plana vitrectomy with corneal wound resuturing. One eye developed corneal wound dehiscence that required wound resuturing in the operating room. One eye developed an inadvertent filtering bleb despite the lack of postoperative suture lysis. Three others were followed up closely postoperatively with slit-lamp evidence of impaired wound healing, manifested by wound avascularity and/or wound gape, and did not require surgical intervention. CONCLUSIONS: The use of nonsteroidal anti-inflammatory agents for prophylaxis of CME after cataract surgery is an evolving trend. This retrospective case series showed a possible link between the use of ketorolac 0.5% and impaired corneal wound healing, and caution is urged in the liberal use of this agent postoperatively after ECCE.

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