Intracameral Ketorolac Concentration After Topical Ketorolac Administration Prior to Cataract Surgery
Purpose
To evaluate the intracameral concentration of ketorolac tromethamine (KE) following topical administration of KE administered preoperatively for cataract surgery.
Methods
Patients undergoing cataract extraction and lens replacement (CELR) were eligible.
Written informed consent was obtained from 14 subjects, who were prescribed topical ophthalmic KE according to the surgeon’s usual practice, beginning the day prior to surgery. Immediately prior to the initial surgical incision, the surgeon withdrew 100 µL of aqueous humor from the operative eye with a 30-gauge tuberculin syringe. At the end of CELR prior to final anterior chamber (AC) re-inflation and wound closure, the surgeon withdrew another 100 µL of fluid from the AC.
The KE concentrations of the intracameral fluid samples were analyzed by an analytical laboratory.
Results
Thirteen of 14 subjects used four doses of KE the day prior to surgery, and one subject used three doses the day prior to surgery. All 14 subjects received topical ketorolac in the surgery center on the day of surgery.
Aqueous humor samples were inadvertently not collected from 2 subjects. The preoperative ketorolac concentrations for the 12 subjects on whom samples were collected ranged from 4.9 to 369 ng/mL. The end of procedure samples ranged from ˂ 1.0 (LLOQ) to 6.32 ng/mL, with 8 of the 12 subjects having KE levels below the lower limits of quantification.
Conclusion
At-home compliance with topical KE was generally good, with 92.9% of subjects using the topical ketorolac as directed. Following CELR, levels of KE in the aqueous humor at the end of the surgical procedure were low, as 66.7% of subjects had an undetectable concentration of KE.